Last week, the Blue Cross Blue Shield Association published a report on its operations headlining that
Blue Cross and Blue Shield (BCBS) companies across the nation are spending more than $65 billion a year—about one in five medical claim dollars—in programs that provide incentives for better health outcomes for patients while reducing costly duplication and waste in care delivery.
The New York Times discussed the report in an article explaining that
Aetna, Cigna and UnitedHealth Group, among others, are also all exploring similar ways of rewarding doctors and hospitals, but the move by the Blue Cross plans is significant because of their size in so many markets. The association estimates the plans have arrangements with 215,000 physicians affecting more than 24 million members, including some in Medicare Advantage plans.
The experiments include paying for care delivered in a medical home, which is not a place, but rather a model where patients are closely followed and their care is coordinated. In its program, Horizon Blue Cross Blue Shield of New Jersey pays a primary care doctor roughly $5 per patient a month to manage a patient’s care. The doctor can earn an additional $11 a month per patient by meeting certain quality and efficiency goals. A practice with 1,000 patients could make an extra $60,000 to $192,000 a year.
The number of specialty drugs in the top 10 keeps rising. In 2020, 9 of the 10 best-selling drugs by revenue are projected to be specialty drugs, compared with 3 drugs in 2010 and 6 in 2013. EvaluatePharma predicts that AbbVie’s Humira [an arthritis specialty drug] will stay on top. You might be surprised at the Solvadi forecast. One oddity: EvaluatePharma doesn’t expect biosimilars to do much harm to 2020’s top drugs.
Sovaldi, the Hepatitis C specialty drug, is projected to be the the fifth best selling drug in 2020 with $4.6 billion in sales.
Finally, yesterday’s Wall Street Journal reported that Bill Gates and Warren Buffett share the opinion that the best book about business is Business Adventures by John Brooks which was written in the 1960s.
It’s certainly true that many of the particulars of business have changed. But the fundamentals have not. Brooks’s deeper insights about business are just as relevant today as they were back then. In terms of its longevity, “Business Adventures” stands alongside Benjamin Graham’s “The Intelligent Investor,” the 1949 book that Warren says is the best book on investing that he has ever read.
The article states that the book is out of print. But Amazon must have been clued into the article because paper and Kindle versions of the book are available on Amazon.com. The FEHBlog has downloaded his copy, and the book is fun reading.