About health insurance
Customers Perceive Shortfall in Medicare Advantage Plan Coverage of Mental Health and Substance Abuse Services, J.D. Power Finds “Following are some of the key findings of the 2022 study:
Overall member satisfaction with Medicare Advantage plans rises: Overall customer satisfaction with Medicare Advantage plans is 809 (on a 1,000-point scale), which is up 3 points from 2021 and up 15 points during the past five years.
Missing the mark on mental health and substance abuse disorder services: Just 38% of Medicare Advantage plan members say they have enough coverage for mental health treatment, down from 39% a year ago. Just 27% of members say they have enough coverage for substance use disorder services. These numbers compare with 91% of members who say they have enough coverage for routine diagnostics and 89% who say they have enough coverage for preventive and wellness services.
Telemedicine usage declines, despite largely positive experiences: Just 24% of Medicare Advantage plan members used telemedicine during the past year, down from 35% in 2021. Among those who have used the technology, however, 48% say they are very likely to use it again, an increase of five percentage points from last year.
Health plan portals still show promise, but breaking inertia is hard: A strong majority (82%) of Medicare Advantage members are registered for their health plan’s member portal—up four percentage points from a year ago. However, 14% have registered for the portal but never logged in. Overall customer satisfaction scores are 72 points higher (823) when customers register and log-in to the portal than when they do neither (751).”
About hospitals and healthcare systems
Fitch: Nonprofit hospitals' outlook 'deteriorating' for remainder of 2022 “Fitch Ratings adjusted its outlook for nonprofit hospitals from ‘neutral’ to ‘deteriorating’ halfway through what has proven to be a rough year for the industry…
’While severe volume disruption to operations appears to be waning, elevated expense pressure remains pronounced,’ Kevin Holloran, senior director at Fitch Ratings, said in a release accompanying the outlook report. ‘Even if macro inflation cools, labor expenses may be reset at a permanently higher level for the rest of 2022 and likely well beyond.’
Fitch anticipates nonprofit hospitals’ operating margins will reflect those pressures through the back half of the year, although many organizations will be able to somewhat weather the storm with the record levels of cash they accumulated last year. Still, asset price corrections in the market are substantially trimming the investment portfolios built up during 2021’s strong markets, the agency noted.”
And in a related story: Inflation Reduction Act may help ease payers' Medicaid losses if public health emergency ends, Fitch says “Payers with large Medicaid operations are expected to face negative pressure on revenues if the federal public health emergency ends in October, but the total impact on profits is likely to be small because of coverage alternatives offered by the Inflation Reduction Act, according to an Aug. 11 analysis Fitch Ratings shared with Becker's.
If the public health emergency is allowed to end October 13, a redetermination process will begin a major disenrollment of Medicaid beneficiaries, likely over the course of a year.
All payers operating Medicaid plans will be affected, but those with higher enrollments are expected to be more impacted. The loss of beneficiaries will be mitigated through the Inflation Reduction Act's extensionof ACA premium tax credits through the end of 2025, which will allow some to regain coverage in the individual market.”
Hospital collection rates for self-pay patient accounts ”As out-of-pocket payment responsibilities continue to rise for patients, hospitals employ more and different efforts to collect these self-pay amounts. But Crowe analytics are showing that after the patient portion reaches into the thousands of dollars, collectability drops off starkly. And that “vanishing point” threshold is now $7,500…
Self-pay after insurance accounts for almost 58% of bad debt.”
About pharma
Walmart, CVS and Walgreens ordered to pay $650 million to Ohio counties for opioid crisis “U.S. District Court Judge Dan Aaron Polster ordered Walmart, CVS Pharmacy and Walgreens to pay a total of $650.5 million to Lake County and Trumbull County over the next 15 years. In the lawsuit, the companies were accused of oversupplying opioids through their pharmacies, contributing to the opioid crisis.”
FDA Approves Citrate-Free, High Concentration of Biosimilar Hadlima “The Food and Drug Administration (FDA) has approved a citrate-free, high concentration formulation of 100mg/mL of Hadlima™(adalimumab-bwwd), a biosimilar to Humira®(adalimumab).” No information is yet available about the price.
About the public’s health
Monkeypox cases jump 20% in 1 week, WHO finds: 5 updates FYI. Among the most worrisome statistic is t “The U.S. accounts for more than 38 percent of global cases.”
And in a related article: Monkeypox Vaccine Maker Seeks Partners in Race to Meet Demand “Bavarian Nordic A/S, the only company with an approved vaccine for monkeypox, said it’s no longer certain it can meet demand and is talking to multiple production partners as cases rise across the world.
The Danish company is exploring the possibility of outsourcing some of its production, including a technology transfer to a US contract manufacturer, to meet accelerating demand.”
Breaking news: Deal struck to expedite production of monkeypox vaccines in U.S. “Under the arrangement, Denmark-based Bavarian Nordic will work with Michigan-based Grand River Aseptic Manufacturing to package 2.5 million doses of vaccine that the United States had ordered in July.”
About healthcare IT
Satisfaction with modes of telemedicine delivery during COVID-19: A randomized, single-blind, parallel group, noninferiority trial “Among a group of diverse, established older or underserved patients the satisfaction rate for phone-only was noninferior to video visits. These findings could impact practice and policies governing telemedicine.”
NY Billing Company Suffers Ransomware Attack, 942K Impacted “New York-based medical billing and practice management company Practice Resources, LLC (PRL) began notifying 942,138 individuals of a ransomware attack that impacted 26 of its healthcare organization clients.
According to a notice posted on the California Attorney General’s Office website, PRL suffered a ransomware attack on April 12, 2022. PRL immediately took steps to secure its systems and gained assistance from third-party experts.
The information involved in the attack potentially included names, addresses, health plan numbers, dates of treatment, and medical record numbers.”
This case highlights the importance of “Business Associate” agreements.
About health technology
Raymond Damadian, Creator of the First M.R.I. Scanner, Dies at 86
New Method Improves Speed and Cost of Birth Defect Testing “After 10 years of effort, medical researchers at Columbia University have developed a very fast and cheap way to detect the extra or missing chromosomes that most often cause miscarriages or severe birth defects.
The method, described Wednesday in the New England Journal of Medicine, takes less than two hours using a palm-size device and costs $200 per use. With current testing procedures, women can end up paying $1,000 to $2,000, often out of pocket.
The technique, developed by Dr. Zev Williams, director of the Columbia University Fertility Center, and his colleagues, uses cells and tissues obtained from existing prenatal screening procedures of embryos and fetuses, or tissue obtained after miscarriages. Its key advantage is that the cells or tissue do not have to be sent to a testing lab — the analysis can be done in the same office that obtained the material, and results are ready in hours rather than days or weeks.”
Guardant Health’s Liquid Biopsy Test Reveal Gets Expanded Clearance “Guardant Health’s Reveal liquid biopsy test received an expanded clearance from the FDA to include patients with breast and lung cancers.
The test works by detecting circulating tumor DNA in the blood after surgery to identify patients with minimal residual disease who have a higher risk for recurrence and may benefit from additional therapy.”
Effectiveness of Standard vs Enhanced Self-measurement of Blood Pressure Paired With a Connected Smartphone Application “Is self-monitoring of blood pressure using an enhanced device that pairs with a connected smartphone application more effective in reducing systolic blood pressure than self-monitoring using a standard device?” The short answer is “No.”
”In this randomized clinical trial of 2101 patients with uncontrolled blood pressure, patients were randomly assigned to standard or enhanced self-monitoring of their blood pressure and mailed a self-monitoring device, after which usual care and in-person clinic blood pressure measurements from ambulatory visits during 6 months of follow-up were used to compare changes from baseline. The mean (SD) change in systolic blood pressure was −10.8 (18) mm Hg vs −10.6 (18) mm Hg in enhanced vs standard groups.”