About health insurance/insurers
Medicare annual enrollment begins “The Medicare annual enrollment period has begun, marked by significant changes in the Medicare Advantage market.
Among these changes are increased government scrutiny, tighter CMS regulations, reduced base payments, and rising healthcare costs among older adults.
In response to these market shifts, many MA carriers are prioritizing their margins over membership by reducing certain benefits and exiting unprofitable markets. As margins tighten and negotiations with providers become more strained, some providers are choosing to no longeraccept some or all MA plans.”
See, also: Changes in store for Medicare Advantage as open enrollment starts
Healthcare Premiums Are Soaring Even as Inflation Eases, in Charts “The cost of employer health insurance rose 7% for a second straight year, maintaining a growth rate not seen in more than a decade, according to an annual survey by the healthcare nonprofit KFF. The back-to-back years of rapid increases have added more than $3,000 to the average family premium, which reached roughly $25,500 this year.
Employers spent about $1,880 more this year, bringing their average cost for family premiums to $19,276. Workers’ share of the average family premium dropped by roughly $280 from last year, to $6,296.”
Blue Cross antitrust lawsuit reaches $2.8B tentative settlement “The Blue Cross Blue Shield Association and its 33 member companies will pay $2.8 billion and change the way they operate under a tentative settlement reached with a collection of providers.
The multipronged settlement would end a 12-year legal battle concerning allegations that the companies and the Chicago-based nonprofit association violated the Sherman Antitrust Act of 1890 by colluding to suppress competition and lower reimbursements. It also would change the companies’ BlueCard Program system for dealing with out-of-network patients.”
UnitedHealth beats the Street with $6B in Q3 profit “UnitedHealth Group kicked off another round of earnings calls for major health insurance companies Tuesday morning, when it reported $6.06 billion in profit for the third quarter of 2024.
That's up slightly from the $5.8 billion the company posted in the third quarter of 2023. However, UnitedHealth has brought in $8.9 billion in profit through the first three quarters of the year, down by close to half from the $16.9 billion reported through the first nine months of 2023…
UHG said that its Optum Health and Optum Rx units led the charge on growth in the third quarter.”
About hospitals and healthcare systems
National Hospital Flash Report “Key Takeaways
1. August data show relatively stable margins. Patient volume has increased, but once adjusted for volume, revenue and expenses have also declined.
2. Average length of stay is trending down. This development indicates less severe patient acuity and efficient care transition pathways.
3. On a volume-adjusted basis, expenses show a slight decline. While expenses are still high compared to previous years, the growth rate is slowing down.”
About pharma
Walgreens to close 1,200 stores: 6 things to know “Walgreens will close around 1,200 retail stores over three years, including around 500 closures in fiscal year 2025, according to its earnings report for the 2024 fiscal year ended Aug. 31.
The company shared plans in June to close ‘a significant portion’ of its underperforming stores in late June due to financial difficulties and ongoing environmental pressures.”
Pharmacist gets up to 15 years in prison for Michigan meningitis outbreak deaths “A Massachusetts pharmacist was sentenced Friday in Michigan to 7 1/2 to 15 years in prison for his role in a 2012 national meningitis outbreak that killed dozens of people…
He already is serving a 10 1/2-year federal sentence for racketeering, fraud and other crimes connected to the outbreak, following a 2017 trial in Boston. The Michigan sentence also will be served in federal prison. He will get more than 6 1/2 years of credit for time already served.
Chin supervised production at the New England Compounding Center in Framingham, Massachusetts, which shipped steroids for pain relief to clinics across the country. Investigators said the lab was rife with mold and insects.”
Recent Trends in Medicaid Outpatient Prescription Drugs and Spending “Key findings include:
The number of Medicaid prescriptions each year was on the decline until FY 2020 when the trend reversed; however, the number of prescriptions only increased by 3% overall from FY 2017 to FY 2023 and the number of prescriptions per enrollee declined.
At the same time, net spending (spending after rebates) on Medicaid prescription drugs is estimated to have increased by 72%, from $30 billion in FY 2017 to $51 billion in FY 2023, likely driven by the emergence of new high-cost specialty drugs.
Rebates reduce Medicaid spending on prescription drugs by over half, but the decrease is larger for fee-for-service (FFS) drug spending.”
About the public’s health
US COVID levels drop, with few flu detections “For COVID, test positivity has declined to 7.7% nationally, but is a little higher in the Western region that includes the Dakotas, Montana, Wyoming, Colorado, and Utah. Emergency department visits for COVID continue to decline. Hospitalizations remain on a downward trend. Deaths also declined, though CDC provisional data show 424 people died from their COVID infections last week…
For flu, activity is still at the low level, and of the few viruses reported by public health labs last week, 55.8% were the 2009 H1N1 strain and 42.2% were H3N2, the CDC in its latest weekly FluView report.”
About health technology
Deep learning AI model scans 'dark matter' of genomic data to find 70,000 never-before-seen RNA viruses “Some of the 161,979 viruses the team sequenced were so different from other RNA viruses that they could form 180 new separate supergroups. Holmes said finding a new supergroup is similar to finding a new phylum of animals—meaning some of these viruses are as different from each other as crabs are to earthworms or cats are to jellyfish.”