What's in — and out — of the debt ceiling deal A really good summary of the healthcare terms of the proposed budget compromise. Highlights include the exclusion of Medicaid work requirements and a claw back of billions in covid-19 relief funds.
About health insurance/insurers
The Value of Employer-Provided Coverage in 2023 “Most consumers (63%) are satisfied with their current employer-provided coverage, and the vast majority (68%) prefer to get their coverage through their employer rather than through the federal or state government. This satisfaction is driven by the comprehensive coverage, affordability, and choice of providers their plans provide. In addition, a majority (59%) feel the quality of their current health insurance plan is high.
During this time of high inflation and rising cost of living, costs remain a top concern for consumers. Encouragingly, a majority of those with employer-provided coverage (53%) report that what they currently pay for coverage overall is reasonable.”
Note: This independent study was commissioned by AHIP.
Milliman Medical Index: Healthcare costs exceed $31,000 for hypothetical American family of four “In 2023, healthcare costs for our hypothetical family of four reached $31,065. Costs for the average person reached $7,221. While these are averages, the MMI provides greater specificity thanks to an interactive tool that allows people to calculate costs for themselves or their own family. To use the interactive tool, go to http://us.milliman.com/MMIfamilies/.”
Note: The figures are averages for an employer-sponsored PPO.
The Shadowy Financial Empire Built Around Liberty HealthShare Is Showing Signs of Strain A great investigative piece by ProPublica that points out the flimsy coverage of ministry-based insurance plans.
Payers ranked by Medicaid membership | Q1 2023 FYI
Healthcare billing fraud: 10 recent cases FYI. Amazing what people attempt to do.
About hospitals and healthcare systems
Ascension posts $1.4B Q1 operating loss “A decline in COVID-19 funding and sustained expenses issues helped lead St. Louis-based Ascension to a $1.8 billion operating loss in the nine months ending March 31.
The nine-month loss was on revenue of $21.3 billion. In the quarter ending March 31, the 140-hospital system reported an operating loss of $1.4 billion on $6.9 billion in revenue.
Such losses compared with $640 million and $671 million deficits in the nine-month and three-month periods, respectively, ending March 31, 2022.”
Trinity Health reports $283.5M operating loss “Livonia, Mich.-based Trinity Health, one of the largest nonprofit health systems in the country, reported an operating loss of $283.5 million for the first nine months of its fiscal year up to March 31.
The loss, which included a reduction of $137.2 million from pandemic-related provider relief funds compared with the same period in 2022, also compared with an operating gain of $139.7 million in 2022.”
About pharma
Sacklers win appeal that shields them from opioid lawsuits, clearing way for bankruptcy settlement “Afederal appeals court ruled Tuesday Purdue Pharma can shield its owners — members of the wealthy Sackler family — from thousands of lawsuits over the role the company played in the opioid crisis in exchange for a contribution of up to $6 billion to a proposed bankruptcy settlement.”
About the public’s health
With population of aging Americans growing, U.S. median age jumps to nearly 39 “The share of residents 65 or older grew by more than a third from 2010 to 2020 and at the fastest rate of any decade in 130 years, while the share of children declined, according to new figures from the most recent census.
The declining percentage of children under age 5 was particularly noteworthy in the figures from the 2020 head count released Thursday. Combined, the trends mean the median age in the U.S. jumped from 37.2 to 38.8 over the decade.
America’s two largest age groups propelled the changes: more baby boomers turning 65 or older and millennials who became adults or pushed further into their 20s and early 30s. Also, fewer children were born between 2010 and 2020, according to numbers from the once-a-decade head count of every U.S. resident.”
About healthcare IT
New collaboration opens CPT content for developers “Under a new collaboration between Health Level Seven® International (HL7®) and the American Medical Association (AMA), technology developers using HL7 data interoperability standards and guides will have increased accessibility to AMA-published medical codes and descriptors. The collaboration will work to fully integrate HL7 Fast Healthcare Interoperability Resources (FHIR®) with the AMA’s Current Procedure Terminology (CPT®) code set to advance the organizations’ mutual goal of promoting the efficient exchange of interoperable health information.”
Top 10 remote patient monitoring platforms, per KLAS FYI
About healthcare personnel
Comparison of Hospital Outcomes for Patients Treated by Allopathic Versus Osteopathic Hospitalists “The results can rule out important differences in quality and costs of care between allopathic versus osteopathic physicians for patient mortality (adjusted mortality, 9.4% for allopathic physicians vs. 9.5% [reference] for osteopathic hospitalists; average marginal effect [AME], −0.1 percentage point [95% CI, −0.4 to 0.1 percentage point]; P = 0.36), readmission (15.7% vs. 15.6%; AME, 0.1 percentage point [CI, −0.4 to 0.3 percentage point; P = 0.72), LOS (4.5 vs. 4.5 days; adjusted difference, −0.001 day [CI, −0.04 to 0.04 day]; P = 0.96), and health care spending ($1004 vs. $1003; adjusted difference, $1 [CI, −$8 to $10]; P = 0.85).
Limitation: Data were limited to elderly Medicare patients hospitalized with medical conditions.
Conclusion: The quality and costs of care were similar between allopathic and osteopathic hospitalists when they cared for elderly patients and worked as the principal physician in a team of health care professionals that often included other allopathic and osteopathic physicians.”
About health technology
Groundbreaking Israeli cancer treatment has 90% success rate “The treatment [for multiple myeloma] is based on genetic engineering technology, which is an effective and groundbreaking solution for patients whose life expectancy was only two years until a few years ago. They have used a genetic engineering technology called CAR-T, or Chimeric Antigen Receptor T-Cell Therapy, which boosts the patient’s own immune system to destroy the cancer. More than 90% of the 74 patients treated at Hadassah [Medical Center in Jerusalem] went into complete remission, the oncologists said.”