Midweek update

Following up on some recent posts

  • Healthcare Dive discusses a Moody’s report on vertical integration actions in healthcare, e.g., CVS Health acquiring Aetna, Cigna acquiring Express Scripts, Walmart acquiring Humana, UHC’s Optum acquiring the DaVita medical group. etc.
  • The Washington Examiner reports on the legislation that the House of Representatives is preparing to address the opioid crisis. 
  • Modern Healthcare informs us that the Drug Enforcement Administration is taking steps to help resolve the shortage of injectable opioid medications that hospitals need.  “Bottom line, this is good news, but it will likely be summer before we have some relief and longer for full relief,” Scott Knoer, the Cleveland Clinic’s chief pharmacy office said.”
  • The Blue Cross Blue Shield Association issued an insightful report on ensuring patient access to affordable prescription medicines. Here are the Association’s themes:

1 Reduce barriers that limit competition and consumer choice, particularly those that limit patient access to new, lower-cost drugs;
2 Promote greater transparency and sharing of information regarding the pricing of prescription medicines;
3 Provide medical and healthcare professionals with the tools they need to support patient education and adherence; and
4 Promote additional regulatory changes that help patients get the right medicines for them, at the most affordable prices.

  • Fierce Healthcare reports on the tong war between commercial health insurers and certain charities, like the American Kidney Fund, over the charities’ practice of paying health insurance premiums for people with end stage renal disease. Why? Commercial payers generate more revenue for the dialysis centers than Medicare does. Of course, the FEHBlog sides with the insurers but it’s noteworthy that these battles have not died down.  HHS needs to act. 
  • Modern Healhcare also tells us that Humana has contracted with five physician practices across the U.S. on a new bundled-payment model for maternity care. Humana’s Maternity Episode-Based Model, which began in January, is a retrospective shared-savings program. Physicians enrolled in the model will receive savings based on their costs and quality performance for Humana members with low- to moderate-risk pregnancies. There is currently no downside risk if the physicians don’t meet the targets.”  Cigna introduced a similar program earlier this year. Horizon Blue Cross of New Jersey has offered a bundled maternity program since 2013.