About health insurance
Health insurance stocks rally as 'Medicare for All' threat weakens: For example, Senator Warren said she would phase in an insurance plan and only propose her Medicare for All plan in the third year of her presidency.
Press Release Finance, Insurance, and Health Care 2018-2019: The American Consumer Satisfaction Index ranked service industries, including healthcare. While this sector ranks lower than others, this year it registered the highest scores in a decade. Read about the rankings of the major plans.
Open enrollment: 83% selecting Medicare Advantage choose plans with $0 premiums: “The number of consumers selecting such plans represent an increase from the 76% who did so last year.”
An Analysis of Charity Care Provided by Hospitals Enrolled in the 340B Discount Program:
“…analysis confirms the average amount of charity care provided by 340B hospitals has declined since 2011, with nearly two out of three 340B hospitals consistently providing below average rates of charity care.”
Medicare improper payment rate fell as new fraud prevention efforts take hold: “The improper payment rate for federal fiscal year 2019 was 7.25%, a decrease from 8.12% in fiscal year 2018, according to a release from the Centers for Medicare & Medicaid Services (CMS) Monday. This is the third consecutive year that the improper payment rate for fee-for-service payments fell below 10%.” Yet Medicare still Lost $31.6 billion in preventable billing errors in FY2018.
Medicare buy-in for older Americans could raise premiums for younger consumers: This article is a summary of a much more complex RAND analysis of a Medicare buy-in plan. (Note: this plan is NOT Medicare for All.) A few interesting takeaways:
Buy-in could attract between 2.8 million and 7.0 million older adults
Creating a Medicare buy-in program for individuals between the ages of 50 and 64 would lower premiums for that age group but also increase premiums for younger consumers on the individual market. While most Medicare premium costs for older Americans would be $10,000 per year in 2022 under a buy-in program, premiums would increase between 3% to 9% for younger consumers.
Savings for an average 50-year-old buying into Medicare would be $2,500 less than buying a gold-level plan on the insurance exchanges established by the Affordable Care Act (ACA). Meanwhile, an average 60-year-old would save $8,000 per year for the same plan (the gold plan—which has an actuarial value comparable to Medicare.
The savings result from lower payments to providers than with private plans.
About pharma
Orphan Drug May Be Frequently Used Off-Label, Inflating Revenue, Letter Suggests: This case study provides great examples of what is wrong with protections on orphan drugs. Two examples: First, for many of these medications much of the profit comes from off-label use. Second, this medication has three orphan indications. For pricing, total sales are not considered as long as one indication is for orphan purposes.
About healthcare quality
New AHA/ACC Performance and Quality Statement on Hypertension: “The American Heart Association (AHA) and the American College of Cardiology (ACC) have jointly published new clinical and performance quality measures for adults with high blood pressure (HBP).
The comprehensive paper, which focuses on diagnosis and treatment of HBP, includes 22 new measures and expands the existing model of care by focusing not only on BP control targets but also on broader care delivery systems and approaches.” While attention to quality details is laudable, do we really need 22 new measures? As quality programs proliferate we need to be aware of the administrative burden of all these measures and scale back to look at fewer key factors that are sufficient to measure performance.