About health insurance/insurers
Medicare Advantage: National Carriers Expand Market Share While Regional Carriers Without Affiliation Decline, 2012–23 “National carriers expanded their national market share significantly from 2012 to 2023, whereas the collective market share of regional carriers without affiliation to Blue Cross and Blue Shield organizations declined because of acquisitions. For example, the combined national market share of national carriers increased from 46 percent in 2012 to 66 percent in 2023, while the combined national market share of non-Blue regional carriers decreased from 25 percent to 6 percent. Conversely, concentration in local markets has declined but remains highly concentrated, and evidence suggests that further declines may be unlikely. Specifically, declines in local market concentration have been limited to markets with low MA penetration. Once MA penetration exceeds 20 percent, further MA growth is not associated with further drops in concentration, on average.”
Optum backs out of proposed 'dummy code' settlement “Optum has backed out of a proposed settlement between Aetna and class members in a lawsuit that accused the companies of improperly charging administrative fees as medical expenses.
In a Dec. 6 court filing, Optum said it disagreed with the settlement's terms and is prepared to proceed to a bench trial. The company also plans to argue that the plaintiffs lack evidence to support their original claims.
The lawsuit, initially filed in 2015, claimed that Aetna and Optum used misleading billing practices — specifically, employing "dummy codes" to disguise administrative fees for chiropractic services as medical charges — thereby causing plan participants and their employers to pay the fees unknowingly.”
About pharma
Walgreens Is in Talks to Sell Itself to Private-Equity Firm Sycamore Partners “Walgreens Boots Alliance and Sycamore Partners have been discussing a deal that could be completed early next year, assuming talks don’t fall apart, according to people familiar with the matter.
Walgreens’s market value reached a peak of over $100 billion in 2015 but had since shrunk to around $7.5 billion as of Monday. Mounting pressures on both its pharmacy and retail businesses had helped send its shares down nearly 70% so far this year before The Wall Street Journal reported on the deal talks Tuesday.”
Pharmacies prevail in appeal of $650-million opioid award in Ohio “Ohio's top court ruled on Tuesday that pharmacy chain operators CVS , Walmart and Walgreens could not be held liable for fueling an opioid epidemic in two Ohio counties that won a $650.9-million judgment against them.
The Ohio Supreme Court held on a 5-2 vote, opens new tab that a state law barred Lake and Trumbull counties' claims that pharmacy chains' dispensing of addictive pain medications created a public nuisance that the companies should be forced to remediate.”
About the public’s health
US health panel adds self-testing option for cervical cancer screening “Women should have the option of taking their own test samples for cervical cancer screening, an influential health panel said Tuesday.
Draft recommendations from the U.S. Preventive Services Task Force are aimed at getting more people screened and spreading the word that women can take their own vaginal samples to check for cancer-causing HPV.
Women in their 20s should still get a Pap test every three years. But after that — from age 30 to 65 — women can get an HPV test every five years, the panel said.”
Biden HHS Extends Covid Vaccine Liability Shield Through 2029 “The US Department of Health and Human Services is extending through 2029 liability protections for those producing and administering Covid-19 vaccines, in a move to guard against future potential health emergencies.”
Dietary guidelines may promote plants but punt on ultra-processed foods “Americans should eat more plant and low-fat dairy foods while limiting their intake of red and processed meats, sugary beverages and foods high in sodium and saturated fat, an advisory committee of health and nutrition experts that helps shape the federal government’s Dietary Guidelines for Americans said in a report Tuesday…
The report, however, drew fierce criticism from some nutrition experts because it did not take a hard stance against ultra-processed foods, which many studies and some lawmakers have blamed for the nation’s rising rates of obesity and chronic disease.”
Bird flu in California child related to virus in dairy cows, CDC says “Federal disease trackers reported Tuesday that the first child diagnosed with bird flu in an ongoing U.S. outbreak was infected with a virus strain closely related to one moving rapidly through dairy cattle, even though there is no evidence the youngster was exposed to livestock or any infected animals.”