Congress reaches spending deal with doc pay bump, delayed DSH cuts and more Good summary of the health provisions.
White House turns to health care in Biden’s latest move against ‘corporate greed’ “The White House plans to announce a new federal task force focused on easing health care costs, according to three people with direct knowledge of the matter.
The move comes as President Joe Biden seeks new ways to show voters he’s cracking down on the so-called corporate greed that he has increasingly blamed for high prices — a message he is expected to highlight during his State of the Union address on Thursday.”
About Covid-19
U.S. suspending free COVID test distribution once again “Orders for free tests placed on or before Friday will be delivered, per HHS.”
About health insurance/insurers
Mounting headwinds in Medicare Advantage market haven’t stopped growth From a Chartis Report: “The following changes are shaping the market:
Enrollment trends: Half of Medicare-eligible individuals are now in Medicare Advantage plans. The market grew by 1.7 million beneficiaries (+5.4%), slowing down from the previous year’s record growth of 2.7 million (+9.4%). Notably, for-profit carriers like United, Humana, and Aetna collectively captured 1.4 million new members: 86% of the total market’s growth.
Special Needs Plan (SNP) growth: SNP enrollment has surged, adding 1.2 million members. Nearly 7 in 10 new Medicare Advantage enrollees opted for SNPs. This growth is particularly pronounced in Chronic Condition SNPs (C-SNPs). The top 5 plans now represent 77% of the SNP market.
Plan options and preferences: The number of plan options are roughly flat from the previous year, with the average senior having access to 44 plans. In contrast, the trend of the past five years has been 80% growth. Preferred provider organizations (PPOs) have increased, constituting 43% of all plans offered, up from 31% in 2019.
Market dynamics and quality: Medicare Advantage enrollment and social vulnerability are related. Counties with higher vulnerability scores show greater penetration rates (53%) compared to counties with lower scores (45%). Meanwhile, quality remains a concern as plans struggle to maintain quality scores. Average star ratings continued their decline and this year approximately one-quarter of beneficiaries are enrolled in a plan with less than four stars.
Market outlook and executive sentiment: Health plans face recent market challenges, including declining payment rates, growing medical cost pressures, and an expanding regulatory burden. But 79% of plan executives express optimism about the next five years, expecting neutral or positive overall outcomes. 84% anticipate membership growth equal to or greater than the current year, indicating confidence in the stability and growth potential of the market.”
About hospitals and healthcare systems
Nonprofits Aspirus Health, St. Luke's Duluth close 19-hospital merger “Wausau, Wisconsin-based Aspirus Health and Duluth, Minnesota-based St. Luke's have closed their merger and are now a 19-hospital entity spread across Minnesota, Wisconsin and Michigan's Upper Peninsula…”
Providers losing $100M daily over Change Healthcare hack: Report “Some larger health systems are bleeding over $100 million daily because of the interruptions to the Optum subsidiary's payer systems, cybersecurity company First Health Advisory told multiple news outlets.”
About pharma
Ohio Fines CVS $1.5 Million Over Safety and Staffing Issues “CVS Health, the nation’s largest pharmacy chain with more than 9,000 locations, has been fined more than $1.5 million by Ohio regulators over problems connected to understaffing and patient safety, officials said.
The fines are part of a settlement of 27 cases involving various safety concerns that were uncovered during a series of inspections of 22 pharmacies between 2020 and 2023, the State of Ohio Board of Pharmacy said in a statement on Thursday.
The board said that it found, among other things, improper drug security, errors dispensing drugs, prescription delays, lack of general cleanliness, understaffing and failure to report losses of controlled substances.”
Mark Cuban says Cost Plus Drugs targeting generic meds in short supply as it opens manufacturing facility “Mark Cuban Cost Plus Drug Company will begin manufacturing its own generic medications this week, starting with sterile injectables, founder and CEO Alex Oshmyansky, M.D., Ph.D., said Monday during a White House roundtable on lowering healthcare costs.
The company, which launched just two years ago, will first manufacture commercial batches of epinephrine and norepinephrine for patients in the intensive care unit…”
Drugmakers send counter offers for U.S. Medicare price negotiations, Biden says “The manufacturers of 10 high-cost drugs selected for the U.S. Medicare program's first-ever pricing negotiations have submitted counter offers to the U.S. government's initial proposal, U.S. President Joe Biden said on Monday.
The negotiation program, passed as part of 2022's Inflation Reduction Act, allows Medicare to negotiate prices for the high-cost drugs. Medicare covers Americans aged 65 and above.”
About the public’s health
Screen Time and Parent-Child Talk When Children Are Aged 12 to 36 Months “Findings This cohort study found a negative association between screen time and measures of parent-child talk across those early years. For every additional minute of screen time, children heard fewer adult words, spoke fewer vocalizations, and engaged in fewer back-and-forth interactions.
Meaning This study suggests that screen time is a mechanism that may be getting in the way of children experiencing a language-rich home environment during the early years; interventions aiming to promote early use of language should include support to manage screen time.”
About healthcare IT
Sixth Semi-Annual Hospital Price Transparency Report February 2024 “Our latest review, conducted three years after the Hospital Price Transparency Rule took effect, analyzed the websites of 2,000 U.S. hospitals and found only 34.5% of them (689) to be fully compliant with all requirements of the rule. Although the majority of hospitals have posted files, the widespread noncompliance of 65.5% of hospitals is due to files being incomplete or not having prices clearly associated with both payer and plan. Eighty-seven of the hospitals reviewed for this report had no usable standard charges file.”
Comment: Where is the federal enforcement?
About health technology
Epigenetic silencing lasts long-term in mice, bolstering case for therapeutic use “Mouse data from a new study published Feb. 28 in Nature and sponsored in part by Chroma Medicine suggest that epigenetic gene silencing can suppress the target gene for nearly a year, providing new evidence for the lasting effects of these therapies…
Epigenetic silencing is similar to gene editing in that both methods act directly on a gene. However, unlike gene editing, epigenetic silencing doesn’t fundamentally change the underlying DNA sequence; it works by “decorating” a gene with compounds, often methyl groups, to stop it from functioning. That makes it possible to reverse epigenetic modifications, as well as to avoid the pitfalls of DNA breakage.”
About healthcare finance
Healthcare real estate companies close $21B merger “Denver-based Healthpeak Properties has closed its $21 billion all-stock merger with Milwaukee-based Physicians Realty Trust. The companies will operate under the name Healthpeak Properties…
The combined company will feature a portfolio of 52 million square feet with footprints in more than 30 markets, including 40 million square feet of outpatient medical settings in high-growth markets such as Houston, Nashville, Tenn., Denver, Phoenix and Dallas with hospital and health system affiliations.”