About health insurance/insurers
AFFORDABILITY SOLUTIONS FOR THE HEALTH OF AMERICA A statement and recommendation from the BCBS Association. It claims their recommendations will save $767B over ten years. One recommendation is to enact single site payments.
Elevance Health posts $949M profit in fourth quarter “Elevance Health reported double-digit revenue growth and beat investor expectations in 2022, but posted a slight dip in profits year-over-year, according to the company's fourth quarter earnings report published Jan. 25.”
Health Insurers Face $3 Billion Medicare Clawback Threat A really good summary of the impact of upcoming Medicare audits to assess overpayments due to excessive severity of illness extra payments.
6.8 million expected to lose Medicaid when paperwork hurdles return “The federal Department of Health and Human Services expects 6.8 million people to lose their coverage even though they are still eligible, based on historical trends looking at paperwork and other administrative hurdles. Pre-pandemic, some states made signing up for and re-enrolling in Medicaid very difficult to keep people off the rolls.
In the three pandemic years, the number of Americans on Medicaid and CHIP – the Children's Health Insurance Program – swelled to 90.9 million, an increase of almost 20 million.”
About pharma
CVS Health debuts new virtual primary care “CVS Health launched new virtual care offerings Jan. 23 focused on primary care and mental health services.
CVS Health Virtual Primary Care includes pre-scheduled primary care and mental health visits as well as on-demand services. All Aetna commercial members in fully-insured and self-insured health plans can use the virtual care platform.”
Kroger to launch its 1st personalized medicine trial “Kroger Health, the national grocery chain's healthcare division, will set up clinical trial sites for research on colorectal cancer gut and immune health with the aim of developing personalized medicines.
It will be the company's first clinical trial…”
Healthcare gets stranger and stranger…
Pharma's 15 biggest lobbyists FYI
J&J Gets Ready to Break Up With Tylenol “Johnson & Johnson confirmed during an earnings call on Tuesday that its consumer health business is on track to become independent this year. Earlier this month, J&J filed for an initial public offering of the unit as a separate company called Kenvue.
The idea of the separation is that, by spinning out its slower-growing consumer unit, J&J will be able to focus on its higher growth divisions: med-tech and pharma.
But in the most recent quarter, it was the consumer unit that delivered growth, while pharma and med-tech were laggards. The main reason for that was the heightened demand for over-the-counter products like Tylenol and Motrin.”
See, also: J&J's profit forecast tops estimates, with key drugs, new launches to drive growth
About the public’s health
USPSTF Declines to Recommend Lipid Tests for All Kids “Citing a lack of available data, the US Preventive Services Task Force (USPSTF) announced Tuesday that it is unable to make a recommendation on whether clinicians should screen children and adolescents for lipid disorders.”
With the X-Waiver repealed, officials urge providers to begin prescribing buprenorphine for opioid addiction “The White House, federal agencies and lawmakers today marked the elimination of the DATA-Waiver Program, better known as the X-Waiver requirement, with calls for providers to begin incorporating opioid use disorder treatment buprenorphine in everyday patient care.
The X-Waiver requirement only permitted doctors who had received specialized training and federal permissions to prescribe the opioid partial agonist, which is a controlled substance.”
How Gen Z sees healthcare: 10 stats FYI
Medical Costs of Substance Use Disorders in the US Employer-Sponsored Insurance Population “Findings In this economic evaluation of 162 million non–Medicare eligible enrollees with employer-sponsored health insurance in 2018, 2.3 million had an SUD diagnosis. The annual attributable medical expenditure was $15 640 per affected enrollee and $35.3 billion in the population; alcohol-related disorders ($10.2 billion) and opioid-related disorders ($7.3 billion) were the most costly.”
About healthcare IT
Payers spent about the same for telehealth or in-person visits in 2020 “Prices were broadly similar for in-person and virtual services. The average cost for established patient evaluations was $33 dollars for in-person care and $34 dollars for telehealth.”
FCC Allows Use of Automated Calls, Texts for Coverage, Enrollment Info “The Federal Communications Commission (FCC) has issued guidance allowing federal and state governmental agencies to send automated calls and text messages providing individuals with information about retaining their enrollment in government healthcare programs.
The declaratory ruling responds to a letter from US Department of Health and Human Services (HHS) Secretary Xavier Becerra, in which the department asked for clarification about which types of calls and text messages were permissible under the Telephone Consumer Protection Act (TCPA).”
About healthcare personnel
Major medical schools join widening revolt against U.S. News rankings “Criticism of ranking system grows as schools based at Stanford, Columbia, U-Penn and Mount Sinai pull out.”