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Marc Ryan

The Healthcare Labyrinth 2023 Year-In-Review

December 28, 2023 No Comments

As I have done for many years, I write a healthcare year-in-review blog to tell you about all the major health stories and trends of the last twelve months. It is meant to be a general assessment and you can check this website’s Newsfeeds and Blogs as well as my LinkedIn posts ( https://www.linkedin.com/in/marc-s-ryan-%F0%9F%87%BA%F0%9F%87%A6-1a99529/ ) for more information.  I break the stories and trends into categories to help your understanding. It is clear that 2023 was a busy year for healthcare, so this blog will be a long one! Here we go! Healthcare, Insurers, and Providers In General In general, 2023 was a continuing year of recovery from the COVID pandemic (2020 to 2022). Healthcare utilization was up again and costs/inflation are returning to normal. We shall see this continue into 2024. We saw moderate inflation in the healthcare sector in 2023 with similar projections for next year (5% to

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December 27, 2023

December 27, 2023 No Comments

Healthcare Lawsuits To Watch in 2024 Good article on the healthcare lawsuits to watch in 2024, including many challenging the Inflation Reduction Act’s (IRA) Medicare drug price negotiations as well as preventive service mandates in the Affordable Care Act (ACA). #aca #ira #exchanges #obamacare #drugpricing Link to Article Lower Quality When Private Equity Firms Acquire Hospitals There is a lot of good data on hospital combinations leading to higher costs and no improvement in quality.  This study points to a rise in adverse events after a private equity takeover of a hospital.  This is despite the pool of lower risk patients in PE targeted hospitals. Additional article here: https://www.medpagetoday.com/publichealthpolicy/practicemanagement/108014 #mergers #acquisitions #hospitals Link to Article Insurtech Overview In 2023 Interesting review of insurtechs in 2023.  In general, insurtechs have been a huge disappointment for investors over the years and the companies have failed to make important gains in the market. 

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December 26, 2023

December 26, 2023 No Comments

Predictions That Hospital M and A Will Pick Up in 2024 The article says that hospital mergers and acquisitions will pick up in 2024. A number of factors are cited, including financial pressures and outside forces. Deals were robust before the COVID pandemic and then collapsed.  They picked up in 2023 and will grow more in 2024. They won’t hit pre-pandemic levels though. New merger guidelines and the Biden administration’s anti-trust views could be a wild card and impact the ongoing recovery of M and A. (Article may require a subscription.) #hospitals #mergers #acquisitions Link to Article Threats From FTC Push Brand Drug Makers To Change Orange Book Entries The Federal Trade Commission’s (FTC) threats to come after brand drug makers who misrepresent patents in the Food and Drug Administration’s (FDA) Orange Book are leading several drug makers to change or pull patent entries.  It is good news as these

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The Insanity of Drug Pricing and Shortages: A Christmas Story

December 26, 2023 No Comments

After what I went through, I asked Santa to bring me a rational drug pricing system for Christmas . But not even the great St. Nick can sort this mess out. Drug shortages or supply disruptions are in the news of late, with serious concerns over the availability of critical cancer and other life-saving drugs. While my drug supply story is not nearly as serious, I write about it today as I have been dealing with it over the Christmas holiday and it shows the pure insanity of our drug supply and pricing system in America. I am withholding the names of the pharmacies and the pharmacy benefits manager (PBM) as not doing so would be unfair to an individual drug chain or PBM. What we see here occurs across the drug supply chain. I am disclosing the drug manufacturers as this helps make clear the complexity of drug pricing.

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December 25, 2023

December 25, 2023 No Comments

The Healthcare Labyrinth Is Off For Christmas Merry Christmas and Happy Holidays to all! — Marc S. Ryan and The Healthcare Labyrinth website.

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December 22, 2023

December 22, 2023 No Comments

Predictions for Healthcare M and A A good article on what to expect in M and A. Discusses consolidation and technology as well as has suggestions for healthcare leaders. #manda #acquisitons #mergers #healthplans #hospitals #providers #2024 Link to Article Government Shutdown Looms Congress does not appear to be any closer to a deal on a FFY 2024 budget to keep government operating. Some CR funding expires on January 19, with the remaining CR ending in February. House Speaker Mike Johnson, R-LA, has proposed a year-long CR at 2023 spending levels. A few months ago, the hard right from which the Speaker hails declared that such a proposal would be terrible given all the COVID spending that has inflated the budget bottom line over the past few years. This led to the ouster of Kevin McCarthy as Speaker and weeks of paralysis on Capitol Hill. Democrats view flat spending as detrimental

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2. World Healthcare System Types and How America Fits In

December 22, 2023 No Comments

Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare. Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through the Healthcare Labyrinth website. Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare. Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America. On this episode of the Healthcare Labyrinth Podcast,

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1. The Debut of The Healthcare Labyrinth Podcast

December 22, 2023 No Comments

Millions of Americans feel confused and frustrated in their search for quality healthcare coverage. Between out-of-control costs, countless inefficiencies, a lack of affordable universal access, and little focus on wellness and prevention, the system is clearly in dire need of change. Hosted by healthcare policy and technology expert Marc S. Ryan, the Healthcare Labyrinth Podcast offers accessible, incisive deep dives on the most pressing issues and events in American healthcare. Marc seeks to help Americans become wiser consumers and navigate the healthcare maze with more confidence and certainty through the Healthcare Labyrinth website. Marc is an unconventional Republican who believes that affordable universal access is a wise and prudent investment. He recommends common-sense solutions to reform American healthcare. Tune in every week as Marc examines the latest developments in the space, offering analysis, insights, and predictions on the changing state of healthcare in America. On this episode of the Healthcare Labyrinth Podcast,

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December 21, 2023

December 21, 2023 No Comments

Prospects In 2024 For Payers and Providers A good article on what is in store for payers and providers in 2024. Included is retail healthcare, health plan investments, hospital struggles, and M and A prospects. #manda #retailhealthcare #healthplans #hospitals #providers #2024 Link to Article Star Achievement In Medicare Advantage Is Key Good article on the financial impacts of the drop in Star power in Medicare Advantage and what plans need to do to get things back on track. Focusing on member satisfaction is key as is measuring well into the future to see how changes will impact ratings, including with the Health Equity change. There also is conversion to digital for a number of Star measures (from manual chart review). Technology investments, including data analytics, are also key. #medicareadvantage #stars Link to Article Will PBM Reform Bill Pass in 2024? Good article on the prospects of PBM reform in 2024.

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Are Health Plans’ Relationships With Owned Entities Fair? Will They Open Up More Regulatory Scrutiny?

December 21, 2023 No Comments

A late November bipartisan letter from Sens. Elizabeth Warren, D-MA, and Mike Braun, R-IN, to the Health and Human Services (HHS) Office of Inspector General (OIG) has many wondering if lawmakers and policymakers will open up a new regulatory front that will bring heightened scrutiny of health insurers’ finances and internal contractual relationships. Let’s give some history first before diving deeper into the issue. With this set up, what does the letter say? Warren and Braun want the HHS OIG to open an investigation on MLR gaming. They are reacting to a recent Brookings Institution analysis and Wall Street Journal (WSJ) report showing the extent of contracting by major insurers with their own subsidiaries and the impact that could have on costs in the healthcare marketplace, especially for consumers. The letter alleges that certain insurers are using these arrangements to evade the minimum MLR rule. In effect, they say insurers

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