About health insurance/insurers
Association Between a Bundled Payment Program for Lower Extremity Joint Replacement and Patient Outcomes Among Medicare Advantage Beneficiaries “Findings In this cross-sectional study of 23 034 lower extremity joint replacement surgical episodes, physician practice participation in a bundled payment program was associated with a 2.7% reduction in episode spending without changes in quality.
Meaning This study found that bundled payments offered by private insurers, including Medicare Advantage plans, may have the ability to reduce spending for lower extremity joint replacement episodes while maintaining quality of care.”
Growth of Medicare Advantage After Plan Payment Reductions “Findings In this cohort study using a difference-in-differences analysis of 3138 counties with 37 639 county-year observations, during the 8 years following the Affordable Care Act, counties with larger cuts to Medicare Advantage plan payments had similar Medicare Advantage enrollment growth as counties facing smaller cuts.
Meaning Payment cuts of the magnitude imposed by the Affordable Care Act did not appear to reduce enrollment growth in Medicare Advantage; modest plan payment cuts may reduce federal spending without compromising access to Medicare Advantage.”
However, read the accompanying editorial, which has many caveats about accepting the results: What Will Cuts to Medicare Advantage Payments Do to Enrollment?
About hospitals and healthcare systems
Comparison of Commercial Negotiated Price and Cash Price Between Physician-Owned Hospitals [POHs] and Other Hospitals in the Same Hospital Referral Region “This cross-sectional study found that nationwide median commercial negotiated prices and cash prices were lower for general acute-care POHs than for non-POHs in the same market for most common hospital procedures. POHs served fewer Medicaid patients and provided less charity care, which might enable them to accept lower commercial prices (these factors were controlled for in the regression models).”
About pharma
GSK settles first Zantac lawsuit due to go before jury in US “GSK said Friday that it reached a confidential agreement to settle the first lawsuit scheduled to go to trial in the US over allegations related to Zantac (ranitidine). The news sent shares in the company up nearly 6%.
The case, brought by Californian resident James Goetz, was due to go to trial on July 24 and would have been the first test of how claims that Zantac caused a variety of cancers would fare before a jury…
The UK drugmaker, along with Boehringer Ingelheim, Pfizer and Sanofi, are facing thousands of such lawsuits in the US over Zantac. A small number of cases are pending in California, while more than 75,000 cases are in state court in Delaware, with hearings likely in January.
Bank of America analysts said they continue to see the Zantac litigation risk as low in absolute terms…”
CMS announces new details of plan to cover new Alzheimer’s drugs “Medicare will cover drugs with traditional FDA approval when a physician and clinical team participates in the collection of evidence about how these drugs work in the real world, also known as a registry. Clinicians will be able to submit this information through a nationwide, CMS-facilitated portal. The portal will be available when any product gains traditional approval and will collect information via an easy-to-use format.”
About the public’s health
E-cigarette sales surge to more than 22 million units per month “E-cigarette sales in the United States surged by nearly 47% from 2020 to 2022 to more than 22 million units per month, according to study findings published Thursday in MMWR.
During the study period, there were increases in both the number of brands and in the sales of disposable devices and flavors that are popular among youth, the CDC noted.”
CDC advisors give nod to 20-valent pneumococcal vaccine for children “CDC advisors on Thursday unanimously supported the addition of Pfizer’s 20-valent pneumococcal vaccine as an option for children in the United States.”
Providing diabetes care that does not meet guidelines increases health costs for patients “Key takeaways:
From 2016 to 2018, about 12% of patients with diabetes received care that did not align with American Diabetes Association guidelines.
The annual burden of improper diabetes care may be as high as $16 billion.”
About healthcare IT
Digital health company Babylon Health to go private in merger with brain tech company MindMaze “Beleaguered digital health company Babylon Health finalized plans to go private and will combine with digital therapeutics company MindMaze.
The take-private proposal comes from investment manager AlbaCore Capital, and the transaction provides for a new capital structure with a significant reduction of pro forma company debt, the company said in a press release.”
About healthcare finance
UnitedHealth outbids Option Care Health for Amedisys in $3.3B deal “Amedisys on Monday agreed to be acquired by UnitedHealth's Optum unit in an all-cash deal while also scraping a previous all-stock deal offer from Option Care Health.
Optum is buying the company for $101 per share, which is a dollar higher than its previous offer and above the $97.38 per share all-stock deal with Option Care in May.
The deal values the company at roughly $3.7 billion, a 10.7% premium to Amedisys’ most recent closing price of $91.21…”