About health insurance
MA Enrollees Can Access COVID-19 Supplemental Benefits in 2021: “New analysis from Avalere finds that… MA plans will continue to increase their supplemental benefit offerings in 2021. More plans will offer primarily health-related benefits, such as meals and transportation. In addition, 1 in 3 MA plans will start offering new types of supplemental benefits specifically related to the pandemic, such as no cost-sharing for COVID-19 testing and care packages.”
Read the report for more details.
Harvard Pilgrim Health Care partners with Foodsmart to offer comprehensive nutrition support to its members “Harvard Pilgrim Health Care has partnered with Foodsmart by Zipongo, a telenutrition and digital foodcare solution based in San Francisco, CA.Foodsmart is a digital nutrition platform that offers online food ordering, immunity-boosting recipes, meal planning for the whole family, and more. The Foodsmart NutriQuiz helps monitor progress against health goals, and facilitates personalization of meal plans and grocery lists based on eating habits, food preferences, allergies, and nutrition needs.” This article explains a recent example of insurers addressing non-medical needs of members.
Cohere Health Announces Partnership with Humana to Modernize Prior Authorization and Improve Physician and Member Experience:”Humana will employ the CohereNext Platform to streamline prior authorizations in musculoskeletal treatment in Alabama, Georgia, Indiana, Kentucky, Michigan, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Virginia and West Virginia. The platform will initially serve approximately 2 million members and more than 3,500 physician practices.”
How will this system for one “organ system” enhance coordination of patient care, particularly if other entities are managing other disease categories?
About the public’s health
CDC expands definition of who is a ‘close contact’ of an individual with covid-19:”The updated guidance, which health departments rely on to conduct contact tracing, now defines a close contact as someone who was within six feet of an infected individual for a total of 15 minutes or more over a 24-hour period, according to a CDC statement Wednesday.”
California Will Independently Verify COVID-19 Vaccine: The headline speaks for itself. Illinois will also independently verify vaccines.
About pharma
Community health centers sue HHS to install method to handle 340B violations after drugmaker feud: “An association representing community health centers is suing the Department of Health and Human Services (HHS), seeking help in combating drug manufacturers that are refusing to give their products to 340B contract pharmacies…
The centers want HHS to install a dispute resolution process to give 340B entities a pathway to remedy program violations.
The lawsuit comes after several drug companies announced they won’t provide 340B-discounted products to contract pharmacies, third-party entities that are hired by a 340B entity to dispense the drugs.”
Remdesivir’s hefty price tag ignores NIH investment in its creation: “Research from the Center for Integration of Science and Industry… determined that between gathering knowledge behind remdesivir’s chemical structure and molecular target, the NIH invested as much as $6.5 billion between 2000 and 2019. This is referred to as ‘basic research’ that might never have resulted in a drug. Instead, the work was performed to learn about the inner workings of cells and organisms and how these systems function as a whole.” This article raises the question of whether governmental investment should be recouped either directly or through lower prices pharma companies charge. The article points out that march-in rights that were “established by Congress under the Bayh-Dole Act, allow the federal government to retain patent rights for inventions developed with government funding, but have never been used. March-in-rights… would allow other distributors to help manufacture remdesivir, increasing the supply and lowering its cost.”