About Covid-19
Covid Vaccines Linked To Small Increase In Heart And Brain Disorders, Study Finds—But Risk From Infection Is Far Higher “Covid vaccines from companies like Pfizer, Moderna and AstraZeneca were linked to rare occurrences of heart, brain and blood disorders, a recent peer-reviewed study found, though experts say the risks of developing Covid-19 greatly outweigh the risks of getting vaccinated.”
About health insurance/insurers
Point32Health Signs Definitive Agreement With Baystate Health to Acquire Health New England “The acquisition is expected to improve product offerings and expand access to a broader network with wider geographic reach. Among both organizations’ shared priorities is expanding high-quality programs and services, particularly those that cover underserved populations and seniors, as well as maximizing the benefits that not-for-profit health plans provide to communities.”
No Surprises Act dispute volume 13 times higher than estimated “There were 288,810 No Surprises Act disputes initiated during the first six months of 2023, which was 13 times greater than federal agencies initially anticipated, according to a Feb. 15 report from CMS.”
New CMS rules will throttle access researchers need to Medicare, Medicaid data Another explanation of why these new data charges will hurt research.
About hospitals and healthcare systems
From STAT, an update on some health systems’ performances:
Allina Health: The $5 billion system is struggling a lot more than most, posting a -6.8% operating margin in 2023. Allina laid off employees and outsourced its billing operations to Optum.
Ballad Health: The last quarter of 2023 was good for Ballad, but the system said it has been having problems with Medicare Advantage plans using proprietary criteria to push patients to lower-paying codes or outpatient observation status, “even if the admission was prior-authorized by the payer.”
Baylor Scott & White Health: Everything’s bigger in Texas, including the hospital profits.
CommonSpirit Health: Patient volumes are up so much across the country that even CommonSpirit is in the black. The hospital giant also disclosed it received $234 million last year from the extra 340B drug payments.
Johns Hopkins Health System: A 12% net margin was fueled by massive investment gains. If patient care doesn’t work out, Johns Hopkins has a future as a hedge fund.
Mass General Brigham: Holy investment income, Batman. It also banked an extra $98 million from 340B drug underpayments.
RWJBarnabas Health: Nurses went on strike for roughly four months at one of the New Jersey system’s main hospitals, and it cost RWJBarnabas $184 million, pushing it into the red. However, if the hospital would have paid its own nurses and avoided a strike, instead of having to hire expensive temporary nurses, it would have turned a profit.
Sanford Health: It turns out that not all rural hospitals are dying! Sanford is one of the largest rural health systems in the country, and yet it was profitable across the board in 2023, surpassing several years of pre-pandemic operations.”
About pharma
Obamacare plans don’t have to cover weight loss drugs. The government is considering changing that “Drugmakers are doing everything to tap the bottomless well of demand for new obesity drugs, and they might get some government help. The agency that regulates Obamacare insurance is considering a technical change that would require insurers to cover obesity drugs in a market of more than 20 million Americans. There is a lot of demand for the drugs, but there are barriers to coverage. Medicare by law is prohibited from paying for obesity drugs. State Medicaid programs don’t have to cover them, so most don’t.”
About health technology
Alabama Supreme Court rules frozen embryos are children, imperiling IVF “The Alabama Supreme Court ruled Friday that frozen embryos are people and someone can be held liable for destroying them, a decision that reproductive rights advocates say could imperil in vitro fertilization(IVF) and affect the hundreds of thousands of patients who depend on treatments like it each year.”