About health insurance/insurers
CENTENE SIGNS DEFINITIVE AGREEMENT TO DIVEST MAGELLAN SPECIALTY HEALTH “ Centene Corporation announced today that it has signed a definitive agreement to sell Magellan Specialty Health to Evolent Health, Inc. (Evolent). Subject to customary purchase price adjustments, Centene expects to receive over $750 million in the aggregate from the transaction.
Centene acquired Magellan Specialty Health, also known as NIA, in January 2022 as part of its acquisition of Magellan Health, Inc. Magellan Specialty Health is a leading specialty benefit management organization that offers industry-leading utilization management solutions to health plans, including radiology management, musculoskeletal management, physical medicine management, and genetic testing solutions.”
Federally-facilitated Exchange Improper Payment Rate Less Than 1% in Initial Data Release “The Centers for Medicare & Medicaid Services (CMS) announced today that the first improper payment rate for the Federally-facilitated Exchange (FFE) program was less than 1% for Benefit Year 2020, thanks in large part to the agency’s implementation of effective automated processes for the program’s eligibility determinations and payments. This finding highlights CMS’ commitment to being responsible stewards of public funds, and to ensuring the sustainability of its programs for future generations.”
About hospitals and healthcare systems
$2.4B Gundersen, Bellin merger to close Nov. 30 “The "merger of equals" was announced June 1 with the goal of both systems offering more resources and services to improve patient care. The health systems will have a balanced leadership structure, with CEOs and board chairs in both regions to have equal representation in decision making for the combined entity.”
Mayo reports $157M Q3 income, salaries and benefits increase 3.5% “Rochester, Minn.-based Mayo Clinic reported a strong third-quarter operating margin despite challenges from workforce shortages and inflation. …
Mayo reported net operating income of $157 million on $4.12 billion for the third quarter of 2022. The health system's operating margin at the quarter's end was 3.8 percent.
Operating expenses hit nearly $4 billion for the quarter as well, a 7.1 percent increase over the same period last year. Salaries and benefits were up 3.5 percent to $2.3.”
Catholic Health suffers credit rating downgrade “Buffalo, N.Y.-based Catholic Health had its credit rating downgraded and is in danger of defaulting on its covenants, Moody's said Nov. 17.
The nonprofit health system, which serves residents in Western New York state with four acute care hospitals and several other facilities, saw its rating on approximately $364 million of debt drop from ‘B1’to ‘Caa2.’ Staffing costs, ongoing impacts from the pandemic and a prolonged labor dispute have resulted in ‘material cash flow losses,’ which are unlikely to go away anytime soon, Moody's said.”
Ascension creates foundation to address health inequities “Ascension, a 143-hospital nonprofit system based in St. Louis, has created a national philanthropic organization that will develop, support and promote health equity initiatives.
The Ascension Foundation will initially focus on programs that address generational poverty and help create economic stability for people, according to a Nov. 17 news release. The organization will also work on creating a diverse future healthcare workforce.”
No Surprises Act Prevents More than 9 Million Surprise Bills Since January 2022 “More than 9 million claims from health care facilities and providers were subject to the protections of the law, which limit out-of-pocket costs for consumers. The number of those claims disputed by providers or facilities has far exceeded the federal government’s initial prediction.”
About pharma
FDA approves Provention Bio's Tzield as first drug to delay onset of type 1 diabetes “The FDA granted clearance to Provention Bio's Tzield (teplizumab-mzwv), making it the first approved drug that can delay the onset of type 1 diabetes. John Sharretts, director of the Division of Diabetes, Lipid Disorders, and Obesity in the FDA's Center for Drug Evaluation and Research, said Tzield's "potential to delay clinical diagnosis of type 1 diabetes may provide patients with months to years without the burdens of disease."
The drug is designed to bind to CD3, a cell surface antigen present on T lymphocytes, and its mechanism is believed to involve partial agonistic signalling and deactivation of pancreatic beta cell autoreactive T lymphocytes. Specifically, Tzield, which is administered by intravenous infusion once daily for 14 consecutive days, is indicated to delay the onset of stage 3 type 1 diabetes in adults and paediatric patients 8 years and older who currently have stage 2 type 1 diabetes.”
About the public’s health
Association of Residential Racial and Economic Segregation With Cancer Mortality in the US “In this ecological study of 3110 US counties, age-adjusted mortality rates were statistically significantly higher for the most deprived counties for all cancers combined and for 12 of 13 selected cancer sites compared with the most privileged counties, with the largest magnitude occurring with lung and bronchus cancer.”