About health insurance/insurers
2024-An Evaluation of Primary Care in Medicare Accountable Care Organizations “The report examines a subset of MSSP ACOs that are primary care centric, as defined by two measures:
—50 percent or more primary care physicians as a percentage of all physicians contracted by the ACO
—Top quintiles of ACOs with respect to primary care evaluation and management (E&M) visits as a percentage of all physician E&M visits, per 100 beneficiaries…
Key findings for the years from 2017 to 2022 include:
—MSSP ACOs in the highest quintiles of primary care centricity were consistently more likely to generate savings and generate savings above the median rate, as compared to ACOs with a lower measure of primary care centricity.
—Primary care centric ACOs outperformed most other ACOs. Concurrently, the median level of shared savings of all MSSP ACOs increased modestly, from 1.1 percent to 3.4 percent.
—High primary care centric ACOs generated 2.4 times the savings as low primary care centric ACOs between 2017–2022.
—By two different measures examined, MSSP ACOs did not appear to achieve these savings by targeting beneficiaries that have fewer social and economic vulnerabilities, although more research is needed at a smaller geographic level to confirm this encouraging finding.”
About pharma
Fierce Biotech's Rotten Tomatoes of 2024 A good summary of this year’s biotech gaffs.
SCOTUS declines to take up PhRMA's challenge of Arkansas 340B drug pricing law “The U.S. Supreme Court refused to hear an appeal by a pharmaceutical industry group challenging Arkansas' 340B drug pricing law.
The decision last Monday affirms a lower court's ruling in March that upheld an Arkansas law prohibiting drugmakers from restricting 340B drug discounts for providers using contract pharmacies.”
Goldman Sachs’ investment arm agrees €2bn deal for drugmaker Synthon “Synthon specialises in developing and manufacturing generic versions of complex drugs. Its portfolio includes treatments for cancer, cardiovascular conditions and multiple sclerosis.”
About the public’s health
How Are States Spending Opioid Settlement Cash? We Built a Database of Answers FYI
And in a related article: Consulting firm McKinsey to pay $650 million to end opioid criminal probe “Business consulting giant McKinsey & Company will pay $650 million to end a criminal probe by the Justice Department into the company’s role in bolstering sales of addictive pain pills, prosecutors announced Friday.”
Texas AG sues out-of-state doctor over mail-order abortion pills “Texas Attorney General Ken Paxton (R) sued a New York doctor this week for allegedly prescribing abortion pills to a suburban Dallaswoman in violation of Texas law — setting up the first major legal challenge to “shield laws” enacted by some Democratic-led states to protect doctors providing abortion access after Roe v. Wade was overturned in 2022.”
Comment: This one is going to The Supreme Court.
About healthcare IT
HHS releases slimmed-down HTI-2 interoperability rule, with more regulations on the horizon “The draft HTI-2 rule, developed by the Assistant Secretary for Technology Policy/Office of the National Coordinator for Health Information Technology (ASTP/ONC), clocked in at 1,067 pages and built on the agency's HTI-1 final rule published in January. It would have established, for the first time, a path for certification for payers. Further, it would have established voluntary certification for health IT software used by public health organizations and health plans.
However, the rule finalized last week, called Health Data, Technology, and Interoperability: Trusted Exchange Framework and Common Agreement, left out many of those broader provisions and mainly focused on advancing TEFCA-related proposals from the draft rule. The pared-down version was only 156 pages, as compared to the hefty draft rule.”