About health insurance
Fewer Medicare Advantage Plan Members Actively Managed Their Health during Pandemic, J.D. Power Finds: “Following are some of the key findings of the 2021 study:
Members’ active management of care declines in 2021: Slightly more than half (55%) of Medicare Advantage plan members actively managed their care in the past year, a decline of nine percentage points from 2019. The two most common ways in which plan members actively manage healthcare are checking whether a treatment or service is covered and asking their doctor or pharmacist for a generic drug instead of a brand name.
Communication still misses mark: Despite improvements in satisfaction with information and communication this year, it is the lowest-performing factor evaluated in the study. Overall satisfaction scores are 54 points higher (on a 1,000-point scale) when members successfully engage with their plan to ask a question or solve a problem than when they have no engagement at all.
New members cite worse health, lower income than established members: Just 34% of new Medicare Advantage plan members (those ages 65-68 or in their first year with the plan) say they are in “very good” or “better” health and 46% say they have an annual income of $50,000 or more. These compare with 39% of established plan members (ages 69+ and not in the first year of the plan) who say they are in “very good” or “better” health and 56% who earn $50,000 or more.
Health plan portals show promise: More than three-fourths (78%) of Medicare Advantage members are registered for their health plan’s member portal—up four percentage points from last year. Two-thirds of members have logged in to their health plan’s portal. Portal use is associated with higher levels of satisfaction and improved member engagement.
Study Rankings
Kaiser Foundation Health Plan ranks highest in Medicare Advantage plan overall satisfaction, with a score of 846. Highmark (834) ranks second and Cigna HealthSpring (822) ranks third.”
7 Fortune 500 health insurers by membership: The top 3:
1. UnitedHealth Group: 49.5 million members
2. Anthem: 43.5 million members
3. Centene: 25.1 million members
4 Philadelphia business owners charged in $10M Medicaid fraud: “Owners of three care coordination agencies allegedly conspired with a transportation company to bill Medicaid for $7.9 million in services from 2017-19 that were never provided to beneficiaries. Two of the companies, Brighter Care Services and Pennsylvania Service Coordination Agency, were accused of defrauding Medicaid an additional $2 million by charging for more services than were provided…”
Medicare Spending on Drugs with Direct-to-Consumer Advertising: Excellent analysis by the GAO:
”Drug manufacturers spent $17.8 billion on direct-to-consumer advertising (DTCA) for 553 drugs from 2016 through 2018, and spending was relatively stable at about $6 billion each year. Almost half of this spending was for three therapeutic categories of drugs that treat chronic medical conditions, such as arthritis, diabetes, and depression. GAO also found that nearly all DTCA spending was on brand-name drugs, with about two-thirds concentrated on 39 drugs, about half of which entered the market from 2014 through 2017.
Medicare Parts B and D and beneficiaries spent $560 billion on drugs from 2016 through 2018, $324 billion of which was spent on advertised drugs. Of the 553 advertised drugs, GAO found Medicare Parts B and D spending for 104 and 463 drugs, respectively. Among the drugs with the highest Medicare spending, some also had the highest DTCA spending. Specifically, among the top 10 drugs with the highest Medicare Parts B or D expenditures, four were also among the top 10 drugs in advertising spending in 2018: Eliquis (blood thinner), Humira (arthritis), Keytruda (cancer), and Lyrica (diabetic pain).”
About the public’s health
Hand Sanitizer Vapors Can Cause Nausea, Dizziness: The FDA is reminding consumers to use sanitizers in well-ventilated areas.
Nutrient Composition of a Selection of Plant-Based Ground Beef Alternative Products Available in the United States: “The percent Daily Value (DV) per 3-ounce cooked portion of each product was determined for nutrients with a DV. The median, interquartile range (IQR), minimum, and maximum nutrient values were calculated for all products by classification as vegan and nonvegan.
Results
The median saturated fat content of the plant-based ground beef alternatives products as a %DV was 4% (IQR 2%). Vitamin and minerals for which median %DV values for plant-based ground beef alternative products were 10% or higher included folate (10%, IQR 10%), niacin (21%, IQR 7%), iron (10%, IQR 5%), phosphorous (10%, IQR 4%), sodium (18%, IQR 7%), manganese (20%, IQR 20%), and copper (24%, IQR 10%). The median dietary fiber content of the plant-based ground beef alternative products was 15% of the DV (IQR 6%). Most of the products contained less protein, zinc, and vitamin B12 than ground beef.”
STDs reach all-time high for sixth consecutive year in the US.: “In 2019 alone, there were more than 2.5 million cases of chlamydia, gonorrhea and syphilis reported, according to the Centers for Disease Control and Prevention. This marks the sixth consecutive year of record-breaking cases of sexually transmitted diseases in the U.S.
The CDC's data looked at states with the highest cases of chlamydia, gonorrhea, syphilis and congenital syphilis. The following numbers were collected from cases in 2019, the most recent data on file, and show a large increase from the reported 1.4 million cases in 2014.”
Dirty Air in Pregnancy Might Raise Baby's Obesity Risk: “The researchers, from the University of Colorado at Boulder, analyzed air pollution data from the U.S. Environmental Protection Agency during the women's pregnancies and then assessed their babies.
Infants whose mothers were exposed to higher levels of air pollution during pregnancy grew unusually fast in their first six months, gaining excess fat that puts them at risk of obesity and related diseases later in life, according to the study.
Specific air pollutants seemed to affect male and female babies differently.”
About hospitals and health systems
Spectrum Health, Beaumont Health announce plans to form 22-hospital system: “Two of Michigan’s largest providers are exploring a potential merger that would yield a 22-hospital nonprofit system staffing more than 64,000 employees.
Spectrum Health and Beaumont Health have signed a letter of intent that places the health systems on track to combine by the fall, the organizations announced Thursday.
In addition to the hospitals, the merged system would also operate 305 outpatient locations and Spectrum’s Priority Health, the third-largest provider-sponsored health plan in the country.”
Recall Beaumont’s previous potential partner was Advocate-Aurora.
Ochsner to take over 7-hospital system: “Rush Health Systems, a seven-hospital system in Meridian, Miss., signed an agreement to join New Orleans-based Ochsner Health.
The organizations said June 17 that they signed a shared mission agreement and expect the deal to be finalized in mid-2022, following necessary regulatory approvals.”
Rush Health Systems is not to be confused with the Chicago-based system with a similar name.
State Supreme Court upholds legality of Colorado hospital fees: “The program requires collection of fees from Colorado hospitals, which are matched by the federal government and then redistributed to hospitals to help them cover Medicaid patients and people in rural areas. The initial provider fee program was started in 2009, a few years later there was a subsequent healthcare affordability and sustainability fee that was added.”
Many other states have used this method to raise monies to obtain federal Medicaid matching funds.
9 hospital construction projects costing $1B+: This list highlights the continuing building boom in this sector.
About healthcare professionals
Device Makers Have Funneled Billions to Orthopedic Surgeons Who Use Their Products: “Every year, a torrent of cash and other compensation flows to these surgeons from manufacturers of hardware for spinal implants, artificial knees and hip joints — totaling more than $3.1 billion from August 2013 through the end of 2019, a KHN analysis of government data found. These bone specialists make up a quarter of U.S. doctors who have accepted at least $100,000 or more, and two-thirds of those who raked in $1 million or more, from the medical device and drug industries last year…”
Top 10 Paying Specialties in the PA Profession in 2020: Some policy experts claim that non-physician professionals could make up deficits in the numbers of primary care doctors. But if salaries for these other specialties are so high, PAs will not be attracted to primary care. Take a look at the list.