About health insurance/insurers
CMS to restrict Medicare Advantage TV ads, scrutinize brokers and agents amid high complaints “Starting next year, insurers will not be able to air any television ads for Medicare Advantage (MA) plans before getting approval from federal regulators.
The new requirement is part of a larger effort by the Centers for Medicare & Medicaid Services (CMS) to address concerns in MA marketing practices. The new effort, announced in a memo released Oct. 19, comes as a Senate panel is also investigating how MA plans reach customers.”
Comment: The requirement is not new. These reviews were in place when Medicare managed care plans emerged in the 1980s.
White House touts 2023 ACA marketplace options as 'most competitive in history' “According to a CMS news release published Oct. 26, 92 percent of Americans will have three or more options to choose from on the marketplace. This number is up from 89 percent last year.”
Health Benefits In 2022: Premiums Remain Steady, Many Employers Report Limited Provider Networks For Behavioral Health From the new Kaiser Family Foundation annual report: ”In 2022 the average annual premium for family health insurance coverage was $22,463, which is similar to the $22,221 reported in 2021. On average, covered workers contributed $1,327 for single coverage and $6,106 for family coverage. Among covered workers enrolled in a plan with a general annual deductible, the average deductible for single coverage was $1,763. Almost half of large employers reported an increase from 2021 in the share of employees using mental health services. The 2022 survey asked employers about the breadth of their provider networks, especially for those using services for mental health and substance use disorders. Employers were less likely to report that their plan with the largest enrollment was very broad for mental health services than for providers overall. Fewer employers thought that their plan had a sufficient number of behavioral health providers versus primary care providers to provide timely access to enrollees.”
Molina's 61% net income boost in Q3 “Molina Healthcare reported a 61 percent increase in net income in the third quarter of 2022 compared to the same quarter in 2021, according to the company's Oct. 26 earnings report…
Molina raised its annual revenue earnings outlook by $500 million to $30.5 billion. The increase was attributed to third quarter outperformance, the Oct. 1 closure of its AgeWell acquisition and the expected impact of the extension of the COVID-19 Public Health Emergency through Jan. 11, 2023.”
Illinois fines Centene subsidiary $1.25M “Illinois insurance regulators are fining Centene subsidiary Celtic Insurance Co. $1.25 million for allegedly failing to cover mental health and addiction services at the same level as other medical issues…”
Comment: Nice to see this parity law is being enforced.
State-Based Marketplace Outreach Strategies for Boosting Health Plan Enrollment of the Uninsured From the Commonwealth Fund: “Key Findings: Most SBMs surveyed invested more in outreach during the open enrollment period for 2022 coverage compared to the previous open enrollment period. Nearly all SBMs extended the annual sign-up window into January. Advertising more-affordable plans under the ARPA helped bring in consumers who found coverage unaffordable under the former, less generous subsidy structure. SBMs conducted data-driven outreach and partnered with other entities to target the uninsured and those likely to need coverage, such as unemployment applicants. Culturally and linguistically appropriate outreach encouraged enrollment among underserved groups.”
About hospitals and healthcare systems
Community Health Systems logs $42M loss, 2.9% revenue decline for Q3 2022 “Community Health Systems (CHS) fell short of consensus estimates for the third quarter, reporting Wednesday evening a $42 million net loss ($0.32 per diluted share) and a 2.9% year-over-year decline in net operating revenues.
The Franklin, Tennessee-based hospital operator’s overall dip to $3.12 billion net operating revenue wasn’t helped by a 1.7% year-over-year increase in total operating costs and expenses ($2.82 billion).
CHS’ revenue decline was driven in part by reduced inpatient volumes. Admissions and same-store admissions decreased by 3.7% and 2.2%, respectively, while adjusted and same-store adjusted admissions increased 3.8% and 5.2%, respectively, the system reported.”
About pharma
Drugmaker raises the price of an old chemo medicine tenfold amid persistent shortages “Amid sporadic shortages of a drug that is essential in preparing patients for lifesaving, cancer-fighting treatments, one manufacturer has returned to the market — but is selling its medicine for 10 to 20 times the prices offered by the only other companies with available supplies.
Over the past week, Areva Pharmaceuticals began marketing vials of fludarabine at a wholesale price of $2,736, a much steeper cost than the $272 charged for the same dosage by Fresenius Kabi and the $109 price tag from Teva Pharmaceuticals, according to data from IBM Micromedex, which gathers pricing data that is reported by manufacturers.”
About the public’s health
FDA Denies Marketing of Logic’s Menthol E-Cigarette Products Following Determination They Do Not Meet Public Health Standard Yesterday the “U.S. Food and Drug Administration issued marketing denial orders (MDOs) for several e-cigarette products currently marketed by Logic Technology Development LLC (Logic). The currently marketed products include the Logic Pro Menthol e-Liquid Package and Logic Power Menthol e-Liquid Package. As a result, the company must not market or distribute these products in the United States or risk enforcement action by the FDA. These are the first menthol e-cigarette products to receive a marketing decision based on a full scientific review from the FDA.”
About health technology
CVS Health rolls out new home tests powered by health tech startup ixlayer “Ixlayer, a health tech company focused on lab testing, is now the platform for CVS Health home tests.
Initial home sample collection kits will target vitamin D, Lyme disease, sexually transmitted infections and thyroid function with a plan to expand early next year, executives told Fierce Healthcare. In addition to the kits, users will have access to a platform that transmits test results and resources for understanding them.”
About healthcare finance
Oracle looks to increase loan size to help fund Cerner acquisition “Software giant Oracle is in discussions with banks to increase the size of a $4.4 billion loan. The company will use the loan to refinance the debt used to fund its $28.4 billion acquisition of EHR company Cerner, Bloomberg reported Oct. 27.”