Today's News and Commentary

About insurance

CMS can terminate private Medicare plans with poor Star Ratings again: After a pause, CMS has resumed its power to terminate Medicare Advantage and Part D plans that have poor ratings (at least 3 stars three years in a row). The “clock” starts with this year’s ratings which come out in the fall; so the soonest terminations will be in 2022.

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Anthem Study Finds More Employers Are Integrating Health Care Benefits Due to Better Health Outcomes, Lower Costs and More Satisfied Employees: Employers have traditionally separated health-related benefits, thus confusing employees. Now, Anthem’s latest edition of its biennial Integrated Health Care report found that “more than 71 percent of the 222 employers with 100+ employees surveyed are either actively integrating or considering integrating their medical, pharmacy, dental, vision and / or disability benefits under their employer’s health and wellness programs in the next five years due to the positive impact integration has on their employees. This represents an 11 percent increase from the study conducted in 2016.” As the title indicates, such an approach lowers costs and boosts employee satisfaction.

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Blue Cross and Blue Shield of Texas Joins Forces with Universities Statewide to Identify Solutions to Fragmentation and Costs in Healthcare: BCBS of Texas, a division of Chicago-based HCSC, announcement details about research projects it is funding with the state’s universities to improve healthcare. A couple examples: Rice University: Evaluate the impact of laws and public policies on health cost and outcomes. Tarleton State University: Examine fraud detection in health claims data.

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UnitedHealthcare expands digital data collection for Medicare beneficiaries: UnitedHealth has announced that it will expand use of its Navigate4Me software to gather data on seniors in its Medicare Advantage plans. Its success so far is exemplified by “a 14% reduction in hospitalizations and a 9% reduction in emergency room visits for people with congestive heart failure.”

Read about the program

About pharma

U.S. top court rejects Maryland bid to revive drug price-gouging law: The Supreme Court refused to hear an appeal by the state of Maryland of a decision finding its law to limit price increases for pharmaceuticals to be unconstitutional. The ruling was based on the prohibition of states to regulate interstate commerce.

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Democrats Introduce Price Gouging Bill: Continuing the theme of the above article, while states cannot pass laws regulating pharmaceutical pricing, Congress can. This announcement is the most recent of many at the federal level to contain pharmaceutical costs.

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Walgreens and CVS are redesigning their drugstores to focus more on health. Here's how they compare: I previously wrote about CVS’s plans to start HealthHUBs in their stores. Walgreens has now joined this trend. This article is a nice summary and comparison of both companies’ approaches to reinventing the “drugstore.”

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About medical education

Free tuition for first 5 graduating classes at Kaiser Permanente’s new medical school; NYU plans new school on Long Island: Kaiser Permanente is starting a new medical school. that will be tuition-free for its first five years. Recently, NYU also announced a free tuition program. Is free tuition or large scholarships a better use of money in higher education than building a new building? Perhaps the philanthropy model can be slowly changed?

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About the public’s health

Effect of low-sodium salt substitutes on blood pressure, detected hypertension, stroke and mortality:Is a low salt diet healthy? Answering this question has been controversial. This literature analysis gives a mixed response: Using low-sodium salt substitutes significantly lowers both systolic and diastolic blood pressure, but overall mortality was unchanged. The authors’ conclusion?: We need a long term randomized control study (of course) to find the answer.

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