Newsfeed

Private Equity’s Role In Healthcare Takes Center Stage At Hearing

Democrat members of the Senate HELP Committee staged a hearing on the role of corporate greed in healthcare.  Of particular concern was the role of private equity firm monies and whether dollars are diverted out from healthcare to corporate margins.  PE firms have big investments in both hospitals and provider groups.

Additional article: https://www.fiercehealthcare.com/regulatory/steward-healthcares-struggles-full-display-clinicians-policy-researchers-tell-senators

#privateequityfirms #healthcare

Link to Article

Read More »

Scrutiny Of Private Equity Healthcare Investments Expand

Private equity investments are already being broadly looked at by Congress and regulators.  Now, the Senate Homeland Security and Governmental Affairs Committee is seeking information on private equity’s role in emergency physician staffing firms that are leaving hospital emergency departments unprepared.

Letters were sent to Apollo Global Management, the Blackstone Group and KKR — three of the nation’s largest private-equity firms — and four emergency medicine staffing companies owned by the firms.  It is estimated at least 40% of hospital emergency departments are overseen by staffing companies that are owned by private-equity firms.

Additional article: https://www.fiercehealthcare.com/providers/senator-probes-private-equity-physician-staffing-firms-emergency-care-cost-cutting

#privateequityfirms #healthcare

Link to Article

Read More »

New GLP-1 Survey Says Growth Is Explosive

A new survey from Virta Health backs up the bleak cost picture. It says that 43% of health plan leaders are predicting 100% or more growth in GLP-1s for weight loss and obesity in 2024. More than half say GLP-1s will be a top 3 drug in 2024 in terms of spending. One fifth say they will be their most expensive drug class this year. Executives believe the media is misrepresenting GLP-1s and that lifestyle programs should be tried first. At the same time, a Vitra Health-linked study comes to a different conclusion on what occurs after stopping GLP-1s.  It says those who stop taking GLP-1s can avoid negative effects on glycemia and body weight if they are properly engaged in their healthcare, including proper nutrition.

See my blog today on the subject: https://www.healthcarelabyrinth.com/whats-all-the-clamor-over-glp-1s-for-weight-loss/

#weightlossdrugs #drugpricing

Link to Article

Read More »

NBA Player Robert Horry’s Healthcare Adventures Are Proof We Need Affordable Universal Coverage

Touching story on NBA great Robert Horry’s healthcare adventures with his daughter, who lived with a genetic disorder and died in her 18th year.  It is a testament to why we need affordable universal access to healthcare.  Horry is now with a company promoting Individual Coverage Health Reimbursement Arrangements (ICHRA), which allows businesses to cover portions of healthcare premiums and allows employees to privately procure insurance (usually on the Exchange). To me, it is one of the few positive healthcare developments from the Trump administration.

#ichra #obamacare #aca #exchanges

Link to Article

Read More »

Change Cyberattack Could Open Americans Up To Multiple Notifications Of Breach

We don’t know yet if Change’s breach will be a record.  But based on the 6 terabyte report of compromise as well as the breadth of the Change system, it very well could be. United is reporting that it may be hard to tell who was impacted by the breach.  Further, because of Change’s tentacles in the market with providers and payers, it could be that people are notified multiple times from different providers and a payer that their data was impacted.  There could be hundreds of millions (even billions) of notifications.  This will cause mass confusion.

In other events, United seems to be complaining that some insurers and providers are slow to reconnect to Change systems, which is needed to get the flow of information and claims.  Some complain that they do not know yet if Change is secure.  They are testing and obtaining independent verification.  Also, some argue that reconnecting is difficult as certain systems are still down. Article here: https://www.modernhealthcare.com/cybersecurity/change-healthcare-update-unitedhealth-reconnect

This other article speaks to the continuing fallout and issues with systems, even those that have been restored.  Things are not business as usual: https://www.modernhealthcare.com/providers/change-healthcare-update-networks-issues

(Some articles may require a subscription.)

#changehealthcare #cyberattacks

Link to Article

Read More »

Improper Payments Huge In Federal Programs

A new Government Accountability Office analysis finds that the federal government made nearly $236 billion in improper payments in 2023. The payments were largely in Medicare, Medicaid, Pandemic Unemployment Assistance, the Earned Income Tax Credit and Paycheck Protection Program loan forgiveness.

Medicare had the largest improper payments at $51.1 billion.  Medicaid had $50.3 billion.

GAO Report here: https://www.gao.gov/products/gao-24-106927

#fwa #medicare #medicaid

Link to Article

Read More »

The Looming Election Year Debate Over The Affordable Care Act

This article captures the big divide between advocates and detractors of the Affordable Care Act (ACA). Good links to various studies.

Proponents say that over 21 million are enrolled in the Exchanges and a total of about 45 million gained coverage including Medicaid expansion.  Opponents argue costs have been huge — 36,798 per additional private insurance enrollee and 20,739 per additional non-group enrollee.  This is well above original estimates. Further, critics say insurers have benefited disproportionately.

Here is my Republican defense of the ACA – as strange as that sounds.

  • Yes we could look at reining in the rich benefit, but upfront coverage even at these costs will ultimately save dollars.
  • At least some of the costs have been caused by poor policy actions that have driven costs under the Obama and Trump administrations.
  • With 45M gaining coverage and tens of millions helped by pre-existing condition rules and the ability to stay on parents’ coverage until age 26, this law is going nowhere.  Reform it – do not repeal it. Opponents have failed to recommend anything that promotes quality coverage.

I also am dubious of the study that says 3 in 4 (73%) U.S. adults “report that in one way or another the healthcare system is failing to meeting their needs.”  Other surveys would suggest general contentment with their coverage and insurer.

#healthcare #healthcarereform #aca #obamacare #exchanges #medicaid 

Link to Article

Read More »

Biden Signs Funding Bill

President Joe Biden signed a $1.2 trillion spending package on Saturday, avoiding a government shutdown. The package includes funding for the Department of Health and Human Services (HHS). The Senate passed the measure 74-24, technically after the deadline.

Additional article: https://www.modernhealthcare.com/politics-policy/spending-bill-passes-hhs-funding

(Some articles may require a subscription.)

#governmentshutdown #spending #healthcare

Link to Article

Read More »

Senate Has Funding Bill After House Passage

The Senate will need to pass a huge funding bill before midnight Friday to avert a government shutdown.  The House passed the bill, which includes healthcare funding, on a vote of  286-to-134 (112 Republicans and 22 Democrats voted against the bill). One conservative House member has called for the ouster of House Speaker Mike Johnson, R-LA, who hails from the Freedom Caucus.  She says she has support from folks, but the caucus and some Democrats do not want to see more chaos. The GOP hold on the House will be razor-thin with two early retirements.

#governmentshutdown

Link to Article

Read More »

Medicare To Cover GLP-1s For Specific Conditions

Medicare Part D will cover obesity drugs if they are approved for specific medical conditions. For example, Novo Nordisk’s Wegovy, just received approval from the Food and Drug Administration (FDA) to reduce risk of stroke or heart attack in people with cardiovascular disease and who are obese/overweight. The same rule will apply to Medicaid. The decision does not make these weight-loss drugs available more broadly.

Additional article on trials showing GLP-1s slowing kidney disease progress and cardiovascular events: https://www.managedhealthcareexecutive.com/view/ozempic-reduces-kidney-disease-progression-cardiovascular-events-by-24-

Additional articles:

https://www.fiercehealthcare.com/payers/wsj-cms-broadens-part-d-coverage-obesity-drugs and https://www.medpagetoday.com/publichealthpolicy/medicare/109305

#weightlossdrugs #medicare #medicaid

Link to Article

Read More »

Available Now

$30.00