About Covid-19
Biden administration to provide free Covid vaccines to uninsured Americans this fall through end of 2024 “The Biden administration on Thursday announced a program to provide free Covid vaccines to uninsured Americans through December 2024 after the federal government’s supply of shots runs out this fall.
Those free shots, which the government is purchasing at a discount, will be available to the uninsured at pharmacies and 64 state and local health departments.”
About health insurance/insurers
CMS outlines 2.8% pay increase for outpatient facilities, ASCs in 2024 proposed rule “In the proposed calendar year 2024 rule, set to be published in the Federal Register, CMS floated payment rates for hospitals that meet applicable requirements for quality reporting at 2.8%, reflecting a projected 3% hospital market basket increase reduced by 0.2% percentage points for a required productivity adjustment.”
CMS proposes payment cuts in physician fee schedule, and docs are crying foul “The Biden administration has released the proposed physician fee schedule for 2024, and a 3.34% decrease in the conversion factor is likely to draw plenty of ire from docs.
The agency said in a press release that under the proposed rule, payments overall would decrease by 1.25% compared to 2023. However, the Centers for Medicare & Medicaid Services (CMS) set the conversion factor at $32.75, down $1.14 or 3.34% from last year.”
FIRST ANNUAL NO SURPRISES ACT REPORT RELEASED “The Department of Health and Human Services' (HHS) Office of the Assistant Secretary for Planning and Evaluation recently released the first annual report on the impact of the No Surprises Act.
According to the report, there was a downward trend in out-of-network claims prior to the No Surprises Act implementation. The prevalence of claims that were out-of-network decreased from 6.0 percent to 4.7 percent from 2012 to 2020. In addition, the share of total payments that were out-of-network declined over this period from 9.2 percent in 2012 to 6.8 percent in 2020, the report said.
The report also says that during that time, out-of-network billing was highly concentrated among a small percentage of physicians from certain specialties.”
UnitedHealth kicks off Q2 earnings with $5.5B in profit, double-digit revenue growth “Profits were up year over year, as the company posted $5.1 billion in profit for the second quarter of 2022. Revenues grew by 16% from the prior year quarter, reaching $92.9 billion compared to $80.3 billion. Both figures surpassed Wall Street analysts' projections…
UnitedHealth Group's double-digit revenue growth overall was bolstered by double-digit gains at both UnitedHealthcare and Optum, according to the report. Revenues at UnitedHealthcare were up 13%, hitting $70.2 billion…
Revenues at Optum were up 25% in the second quarter, reaching $56.3 billion. The Optum arm has been a major growth engine for UnitedHealth Group in recent quarters.”
About hospitals and healthcare systems
Why hospitals are cutting ties with Moody’s rating agency “Not-for-profit hospitals have been cutting ties with Moody’s Investors Service in recent years, citing the high cost and time commitment required to maintain their relationships with the rating agency.
With labor and supply costs inflated and margins thin following the Covid-19 pandemic, hospitals are eager to trim any expenses they can. Increasingly, that means cutting a bond rating. It’s common for health systems to have their bonds rated by just two or even one of the three major credit rating agencies —Moody’s, S&P Global Ratings, and Fitch Ratings.
But when deciding which one to ditch, data show they’ve more commonly targeted Moody’s in recent years. At least 10 health systems have ended their agreements with Moody’s since July 2020…”
About pharma
Ozempic demand is driving up care costs nationwide The headline is the story.
About the public’s health
Medicare proposes coverage for PrEP without patient cost sharing “The Centers for Medicare & Medicaid Services (CMS) is recommending preexposure prophylaxis (PrEP) with oral or injectable antiretroviral therapy to people at risk of HIV without patient cost sharing.
In addition, CMS is proposing to cover the administration of injectable PrEP and up to seven individual counseling visits every 12 months that include HIV risk assessment, reduction and medication adherence. The agency is also pitching coverage for HIV screening up to seven times annually and a single screening for hepatitis B virus, according to a press release.”
White House planning to tap retired general to lead new pandemic office “Maj. Gen. Paul Friedrichs, who retired from the military this summer and joined the National Security Council to work on biodefense and global health security, is the planned selection to lead the White House’s Office of Pandemic Preparedness and Response Policy, according to three people who spoke on the condition of anonymity to discuss a pending personnel move.”
About healthcare finance
Hungry for more, Lilly tops off weight loss pipeline with $1.9B deal to acquire Versanis “The Indianapolis-based company has signed off on a $1.92 billion deal, which covers an upfront payment and potential milestones, for Boston-based Versanis and lead asset bimagrumab.
The monoclonal antibody is already in a phase 2 trial both alone and in combination with semaglutide in adults who are overweight or obese.”