Read today’s Kaiser Health News
In other news:
These 6 Charts Explain Why the Government Shut Down Excellent article explaining why the shutdown is largely about healthcare issues.
CMS finalizes guidance for 3rd round of Medicare drug price talks: CMS has finalized several changes for the third round of Medicare drug price negotiations.
The changes, outlined in a final guidance issued Sept. 30, include expanded exclusions for orphan drugs and a new framework for incorporating Medicare Advantage encounter data into drug selection calculations under Part B.
About health insurance/insurers
How Insurers That Own Providers Can Game The Medical Loss Ratio Rules This tactic has been known for quite a while. [I have taught it in class for many years.] Insurers can pay higher rates to other parts of the same company to avoid penalty payments that would result from a too-high Medical Loss Ratio. That said, I have always wondered why United Health ever pays penalties.
Insurers launch 2026 Medicare Advantage plans: MA open enrollment is from Oct. 15 to Dec. 7, The article explains some major changes from large plans.
About hospitals and healthcare systems
Days cash on hand at 40 health systems FYI
340B rebate pilot would cost hospitals $400M: AHA: If HHS’ 340B rebate model pilot proceeds as planned, more than 2,700 U.S. hospitals will collectively be saddled with approximately $400 million in operational costs and 11.2 million labor burden hours, according to the American Hospital Association.
The rebate model, slated to go into effect Jan. 1, will allow drug manufacturers that are part of CMS’ first cycle of negotiated drug prices to provide rebates — rather than upfront discounts — for 340B entities. Congress established the 340B program in 1992 to require drugmakers to sell specific outpatient drugs to eligible providers at discounted prices.
About the public’s health
High consumption of ultra-processed food [UPF] and risk of colorectal cancer:[CRC]: the Norwegian Women and Cancer cohort study: A high UPF intake (fourth quartile), compared with a low UPF intake (first quartile), was statistically significantly associated with increased total CRC risk after adjusting for all covariates and energy intake (hazard ratio (HR) = 1·24; 95 % CI 1·04, 1·49, Pfor trend = 0·02). Furthermore, a high UPF intake, compared with a low UPF intake, was statistically significantly associated with right-sided colon cancer (HR = 1·58; 95 % CI 1·19, 2·09, Pfor trend < 0·001).