Tuesday Tidbits

The FEHBlog returns to DC tonight following a tour of duty watching over his grandson. It’s raining here in NYC but the rain is nothing like the rain that’s fallen on Houston. Becker’s Hospital Review reports on Hurricane Harvey’s impact on healthcare in Houston.  Here’s a link to OPM’s FEHB related hurricane guidance.

Healthcare Dive reports that Anthem is implementing a new policy under which it will cover outpatient MRIs and CT scans in free standing imaging centers but not at hospitals.  Healthcare Dive observes that

Hospitals are continuing to increase the outpatient care they perform for a number of reasons. Patients often find it more convenient, and payment rates are usually higher than for services performed at a physician’s office. Imaging done at a stand alone clinic can be drastically cheaper, and Anthem is looking to cut costs its deems unnecessary.

The largest payer in the country is as well. The CMS has a proposal to make costs more site neutral by paying services at off-campus hospital outpatient departments at 25% of regular outpatients rates. The same proposal also includes a small increase (1.75%) for outpatient payments. The American Hospitals Association generally opposes site-neutral regulations, arguing the change could reduce patient access to care. But other healthcare organizations, including the American Medical Association, say it levels the playing field and helps smaller practices stay afloat.

In the mergers and acquistions arena —

  • The Financial Times muses about a recent Gilead Science’s acquisition. Gilead made a boatload of money by acquiring Pharmasset, a company that developed a Hepatitis C cure known as Solvadi. Gilead yesterday acquired Kite for about $12 billion. Kite is “one of the leading companies in the pioneering field of chimeric antigen receptor therapy or Car-T, a one-time treatment that involves re-engineering a patient’s blood cells so they can identify and attack cancer.”  
  • Reuters reports that “Advisory Board Co said it would sell its healthcare business to UnitedHealth Group Inc’s Optum unit and education business to private equity firm Vista Equity Partners, for a total deal value of $2.58 billion.”
The Health Affairs Blog discusses a recent National Academy of Medicine study on how to reduce healthcare costs by redesigning care for high need patients. The study principally provides advice to health care providers but it also explains the role for payers and the government. 
Finally on the information technology security front,
  • Beckers Hospital Review offers an Security Scorecard ranking of 18 industries based on their level of cybersecurity protections. The FEHBlog is not sure whether health insurers fall under financial services (ranked fifth) or healthcare (ranked 13th). The FEHBlog guess is the former. 
  • HHS’s Office for Civil Rights, which is responsible for enforcing the HIPAA Privacy and Security Rules, has a new feedback form, which is capable of accepting many categories of feedback. 

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