About health insurance/insurers
Payers ranked by commercial membership | Q1 2023 Elevance (formerly Anthem) is #1.
About hospitals and healthcare systems
1,129 hospitals reporting losses on patient services, state-by-state “Rural hospitals across the U.S. are taking losses on patient services, meaning insurers aren't paying enough to cover the cost of care delivery, according to a report from the Center for Healthcare Quality & Payment Reform.
Losses on patient services have forced some hospitals to close service lines and reduce access to care in already underserved communities. There are more than 600 hospitals at risk of closure across the U.S. as well due to financial constraints and inflation.”
About pharma
Top PBMs by 2022 market share FYI. CVS Caremark is at the top with 33% market share.
New overdose antidote approved, but concerns raised about cost, side effects “The Food and Drug Administration on Monday approved a nasal-spray medication touted as another option to reverse overdoses caused by synthetic opioids, including fentanyl, the drug killing tens of thousands of Americans each year.
Drugmaker Indivior describes Opvee, a spray version of the drug nalmefene, as a potent medication that will save lives by acting quickly to reverse an overdose while potentially protecting against more overdoses for hours. But some public health experts, physicians and community groups are raising concerns that Opvee may burden taxpayers despite other proven, cheaper medications such a naloxone while causing agonizing, long-lasting withdrawal symptoms for some drug users after they are revived.”
Purdue Pharma to Sell Consumer Business for $397 Million “Purdue Pharma on Tuesday received a US judge's permission to offload its consumer health business for $397 million to a subsidiary of Arcadia Consumer Healthcare, reported U.S. News & World Report.
US Bankruptcy Judge Sean Lane approved Purdue's sale of Avrio Health, allowing Purdue to begin liquidating its assets while it awaits a final ruling on a $10-billion settlement that would devote the company's remaining resources to combating the US opioid epidemic.”
U.S. proposes new rule to increase transparency of prescription drug costs for Medicaid “The U.S. health department on Tuesday proposed a rule aimed at cutting costs of prescription drugs for the Medicaid healthcare program for the poor by increasing transparency around how much those drugs actually cost.
The proposed rule would also hold drugmakers accountable for providing the correct discounts to the state-based Medicaid plans for drugs.
The Centers for Medicare and Medicaid Services (CMS) proposed that contracts between states, health insurers and third-party contractors such as pharmacy benefit managers show how much those PBMs are paying for the drugs to avoid discrepancies in what they charge Medicaid and what they reimburse pharmacies.”
Walgreens asks federal court to toss 'staggering' $642M arbitration award to Humana Read the entire article for the complete story. It will be in the news for a long time.
Walgreens Nears Settlement In Theranos MDL “Walgreens has reached a settlement in principle with a class of customers who submitted Theranos blood tests in a years-long case alleging the pharmacy chain should have known the tests were faulty when it helped market them.”
About the public’s health
What is Driving Widening Racial Disparities in Life Expectancy? “This analysis examines trends in life expectancy and leading causes of death by race and ethnicity and discusses the factors that contribute to racial disparities in life expectancy. In sum, it finds:
There was a sharp drop-off in life expectancy between 2019 and 2021, with particularly large declines among some groups. American Indian and Alaska Native (AIAN) people experienced the largest decline in life expectancy of 6.6 years during this time, followed by Hispanic and Black people (4.2 and 4.0 years, respectively).
Reflecting these declines, provisional data for 2021 show that life expectancy was lowest for AIAN people at 65.2 years, followed by Black people, whose expectancy was 70.8 years, compared with 76.4 years for White people and 77.7 years for Hispanic people. It was highest for Asian people at 83.5 years. Data were not reported for Native Hawaiian and Other Pacific Islander (NHOPI) people.
These declines were largely due to COVID-19 deaths and reflect the disproportionate burden of excess deaths, including premature excess deaths (before age 75), among people of color during the pandemic. Although COVID-19 mortality was a primary contributor to the recent decrease in life expectancy across groups, leading causes of death vary by race and ethnicity.”
Surgeon General issues advisory that social media is contributing to youth mental health crisis “Murthy specifically pointed to the possibility of a link between time spent on social media and depression and anxiety.
He cited one 2019 study that found adolescents between the ages of 12 and 15 who spent more than three hours on social media daily had double the risk of developing symptoms of depression and anxiety.
Teenagers on average spend 3 1/2 hours on social media every day, according to data cited in the advisory.
About healthcare IT
Mayo Clinic, Johns Hopkins and 20 others pledge to join TEFCA, prioritize interoperability “Epic announced the first cohort of health systems pledging to join the national health information-sharing network dubbed the Trusted Exchange Framework and the Common Agreement (TEFCA).
Epic is a member of the inaugural group of six prospective Qualified Health Information Networks (QHINs) that were recognized by the Department of Health and Human Services (HHS) earlier this year. Today, Epic announced that 20 health systems along with health tech company KeyCare and health information exchange OCHIN will be joining TEFCA with the goal of increasing interoperability in healthcare.”
Note: See the Information Technology chapter in the Book for more information about TEFCA.
State Telehealth Laws and Reimbursement Policies “This chart provides a quick reference summary of each state’s telehealth policy on Medicaid reimbursement, private payer reimbursement laws (both if a law exists and whether or not payment parity is required), and professional requirements around interstate compacts and consent based on information gathered between January and March 2023.”
EHR vendors ranked by hospital market share gains (and losses) No surprises on this list.