Recap Of Q2 Health Plan Financials
A good recap in Modern Healthcare on Q2 financial results of big health plans and strategies they are employing to get back to margin. The secret in Medicare Advantage (MA) will be to prioritize margin over enrollment and growth. United and Aetna have already sent word they will pare back offerings. The secret in Medicaid will be strong lobbying efforts in each state for rates and to offset program reductions. Premium increases will dominate the Exchanges. I especially liked Elevance Health’s promise to continue legal challenges against providers on the No Surprises Act independent dispute resolution process. Bravo. It is abused by a small group of providers. In general, the provider-friendly process will drive up prices throughout the system.
(Article may require a subscription.)
#healthplans #margins #medicareadvantage #medicaid #exchanges
https://www.modernhealthcare.com/insurance/mh-aetna-cigna-unitedhealth-centene-q2-earnings
Optum Acquires More Docs
Optum has acquired Kingsport, Tenn.-based Holston Medical Group. The 200-provider medical group has more than 70 locations in Northeast Tennessee and Southwest Virginia.
#providers #healthplans #acquisitions
https://www.beckerspayer.com/m-and-a/optum-acquires-200-provider-medical-group
Patent Thicket Legislation Examined
A good article in Health Affairs Forefront Blog discussing various pieces of legislation on reforming so-called regulatory thickets that curb early introduction of generics and biosimilars and hurt robust competition. It is a good assessment of the strengths and weaknesses of the two main bills and a recommended strategy. Patent thicket lawsuits are one of many things brand drug makers use to extend their exclusivity periods. Reform needs to happen.
(Article may require a subscription.)
#drugpricing #branddrugmakers #generics #biosimilars #patents
— Marc S. Ryan
