About health insurance/insurers
Payers ranked by Q3 profits The nation's largest payers have filed their third-quarter earnings reports, revealing which recorded the largest profits.
Payers ranked by Q3 profits:
UnitedHealth Group: $6.1 billion, up 3.7%
Elevance Health: $1 billion, down 21%
Cigna Group: $739 million, down 47.5%
Centene: $713 million, up 52%
Humana: $480 million, down 42%
CVS Health: $87 million, down 96%”
About hospitals and healthcare systems
General Catalyst to acquire Summa Health for $485M “Summa Health comprises multiple hospitals, community medical centers, a health plan, an accountable care organization, a multi-specialty physician organization, research and the Summa Health Foundation.”
Akron, Ohio-based Summa Health has reached a $485 million definitive agreement to join Health Assurance Transformation Corp.[HATCo], according to a Nov. 7 news release. ..
The parties shared plans for HATCo to purchase Summa Health in January, with plans to close the deal by the end of 2024.
Under the agreement, the $485 million purchase amount will help Summa Health, which will transition into a for-profit structure, pay off $850 million in debt. Summa Health's remaining cash will fund a new, separately governed community foundation to support community investment in the Akron area.”
About pharma
GoodRx, PBMs accused of suppressing reimbursements “GoodRx and pharmacy benefit managers CVS Caremark, Express Scripts, MedImpact and Navitus Health Solutions are facing class-action lawsuits accusing them of colluding to suppress reimbursements to independent pharmacies for generic drug prescriptions.
Three lawsuits were filed last week, with the first filed by Minnesota-based Keaveny Drug in federal court in California on Oct. 30. A second class-action lawsuit was filed Nov. 1 by Michigan's Community Care Pharmacy in the same court, and the third lawsuit was filed the same day by Pennsylvania's Old Baltimore Pike Apothecary and Smith's Pharmacy in federal court in Rhode Island.
The lawsuits claim that starting in 2023, GoodRx partnered with PBMs to reroute patient prescriptions to whichever PBM offered the lowest price for generics, bypassing the patient's designated PBM. Pharmacies are charged a fee for these transactions, which is split among PBMs, but receive no reimbursements from dispensing the drugs, which result in financial losses for independent pharmacies…”
Acadia pockets $100M from paediatric voucher sale After scoring the first FDA approval for a Rett syndrome treatment last year, Acadia Pharmaceuticals has now sold the rare paediatric disease priority review voucher it gained along with the greenlight. Acadia said the voucher sold for $150 million, but did not disclose the buyer. The drug developer will only profit $100 million off the sale, however, as Neuren Pharmaceuticals — from whom Acadia gained North American rights for Daybue — is entitled to one-third, or $50 million, of the proceeds.”
FDA Updates GLP-1 Label With Pulmonary Aspiration Warning “On November 5, the US Food and Drug Administration (FDA) updated the labels for all glucagon-like peptide 1 receptor agonists (GLP-1 RA) with a warning about pulmonary aspiration during general anesthesia or deep sedation. The affected drugs are semaglutide (Ozempic, Rybelsus, Wegovy); liraglutide (Saxenda, Victoza); and the dual glucose-dependent insulinotropic polypeptide (GIP)/GLP-1 tirzepatide (Mounjaro, Zepbound).”
About healthcare IT
CMS finalizes telehealth pay changes: 5 notes FYI
About healthcare technology
VHA2024 STATE OF INNOVATION REPORT FYI- Annual update on innovation in the Veteran’s Health Administration.
About healthcare personnel
Patient Travel Patterns and Concordance With Geographic Market Boundaries Among physician visits, the median travel time was 12.7 minutes (IQR, 7.0 to 22.3 minutes) for primary care and 17.1 minutes (IQR, 9.5 to 30.8 minutes) for specialty care. Median travel time was longer for patients living outside metropolitan statistical areas (MSAs), especially for specialty care (15.9 minutes inside vs. 41.8 minutes outside MSAs). For ED visits, the median travel time was 13.6 minutes (IQR, 7.5 to 24.2 minutes).”