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December 13, 2023

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CMS Actuary Releases 2022 Healthcare Statistics

The CMS Actuary has released its analysis of 2022 national healthcare expenditures. I will write a blog on this in the next week. At the link is the website where the data is uploaded. Centers for Medicare and Medicaid release here: https://www.cms.gov/newsroom/fact-sheets/national-health-expenditures-2022-highlights .

In addition, four other articles on the new data: https://www.fiercehealthcare.com/payers/back-normal-health-care-spending-growth-rates-down-pandemic-era-times and https://www.healthaffairs.org/content/forefront/ahead-print-national-health-spending-2022 and https://www.modernhealthcare.com/policy/us-health-care-spending-rose-over-4-trillion-2022 and https://insidehealthpolicy.com/daily-news/cms-2022-health-spending-report-finds-medicaid-drove-federal-spending .

Healthcare spending increased 4.1% in 2022 to $4.5 trillion. In 2022, the share of the economy devoted to healthcare spending as a percentage of gross domestic product (GDP) was 17.3 percent. Healthcare’s share of GDP as well as the percentage cost increase both went down in part due to lower government spending on the pandemic from prior years. In addition, Medicaid spending due to enrollment growth was very high.

(Some articles may require a subscription.)

#healthcare #costs

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December 12, 2023

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A Rare Occurrence For Healthcare Costs

In a rare occurrence, medical service costs at hospitals increased 2% in the first three quarters of 2023. This is about the 1.9% that the economy grew. Generally, hospital costs tend to far exceed economic growth and inflation. The report is from Turquoise, a new price transparency startup.  The findings also show that costs can vary across regions/markets as well as within markets.

#pricetransparency #healthcare

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December 11, 2023

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Cigna-Humana Merger Off — For Now

The Cigna-Humana merger is reportedly off as the entities could not arrive at financial terms. This leaves Cigna with two big decisions: (1) What smaller deals will they enter into? and (2) Will they sell their Medicare Advantage (MA) business? While MA is a smaller portfolio than many big plans have, if it can improve its Star scores and make additional investments, it could still be lucrative for Cigna. On the other hand, Cigna may be investing most of its efforts in its non-margin-limiting Evernorth services subsidiary. Additional articles: https://www.modernhealthcare.com/mergers-acquisitions/cigna-humana-merger-deal-scrapped-stock-buyback and https://www.healthcaredive.com/news/cigna-humana-deal-falls-through-wall-street-journal/702091/ and https://thehill.com/policy/healthcare/4353008-cigna-ends-plans-to-merge-with-humana-report/

(Some articles may require a subscription.)

#healthplans #mergers #acquisitions #cigna #humana

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December 8, 2023

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New Poll On Affordable Care Act And Healthcare Issues

A new poll shows that the American public favors maintaining the Affordable Care Act and reforming the current healthcare system. My blog Monday will build on my December 7 blog and go deep into this poll.

#healthcare #healthcarereform #affordableuniversalaccess #universalaccess

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December 7, 2023

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United Health Foundation Says Chronic Conditions Rising

The United Health Foundation released a study that concludes chronic conditions are rising in the U.S. It also released its annual “America’s Health Rankings” report, which tracks health across the country based on 87 measures and 28 data sources.

United finds that persons with multiple chronic conditions has reached their highest levels since they were first tracked. Mental health and diabetes have risen.  It also found health condition disparities exist for asthma, COPD, and diabetes. United also found that more people have multiple co-morbidities.

United calls for investments in care management as well as health equity.

As I note in my book, The Healthcare Labyrinth (available on this website), one of America’s key problems is a lack of investment in health, wellness, and care management.  Other developed nations concentrate resources here and have much better outcomes, fewer people with disease states and conditions, and have better maintenance of conditions. 

There is no question plans need better data and analytics in order to intervene not only at the member level, but also at the group level to tackle social determinant barriers and health equity. This is a good place for plans to focus as the prior authorization area becomes much more constrained via regulation.

#healthcare #chronicconditions #disparities #healthequity

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December 6, 2023

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Affordable Care Act 2025 Rule And Ongoing Press On Trump Repeal Remarks

While we have already covered the proposed 2025 Exchange rule, this article from Kaiser Health News discusses the rule as well as some of the history of the Affordable Care Act under Trump and later Biden.

#aca #obamacare #exchanges #medicaid

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December 5, 2023

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Is Interest In ACA Truly Fading?

The Kaiser Family Foundation (KFF) poll says that the ACA and generally healthcare are fading as issues in the 2024 campaign.  The poll was done before Donald Trump’s remarks on the Affordable Care Act (ACA).

But let me take a slightly contrarian view here.  As the poll notes, about half of the 1,401 people surveyed said the future of the ACA is a key topic.  About 70% of Democrats thought so and 32% of Republicans thought so.  To me, in a close election, 32% of Republicans thinking the ACA is significant is, well, significant.  In a close election, how do you win if one-third of Republicans and a greater percentage of independents care about an issue?

KFF poll here: https://www.kff.org/health-reform/press-release/poll-by-a-wide-margin-democratic-voters-now-care-more-about-the-affordable-care-act-than-republican-voters-do-and-voters-trust-democrats-more-than-republicans-to-handle-its-future/

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

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December 4, 2023

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U.K. National Health Service Has New Drug Pricing Deal

An article in The Economist discusses the United Kingdom’s new drug pricing deal.  As we know, all other developed nations negotiate and set prices globally, as Great Britain does. The Inflation Reduction Act’s Medicare drug price negotiation will slowly bring some of what other developed nations have. In fact, we have some in force now.

Key points from the article:

  • The U.K. has among the lowest drug prices in the world because of its buying power.  Imagine the buying power of America?
  • The U.K. looks at the cost-effectiveness of new medicines to set prices.
  • It also has inflationary caps of 2% per year, which will increase to 4% in the new deal. Anything over this is returned in a rebate. Some drugs are exempt to encourage innovation.

Still, the U.K. says it is getting hurt by high-cost cancer and other drugs.

The U.K. and other systems work and should be fully in place in America.

(Article may require a subscription.)

#drugpricing #medicare #partd #uk #nhs

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December 1, 2023

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Cigna-Humana Deal Could Pass Muster

While federal and state regulators will look closely and potentially oppose a combination, experts seem to think that the Cigna-Humana merger could eventually go through.  As I have indicated as well, the company profiles are quite different than earlier deals that fell through.

#cigna #humana #mergers #acquisitions

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November 30, 2023

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Walgreen’s Launches Drug Tool

Similar to others, Walgreen’s has launched a drug price transparency and saver tool for its customers. No monthly fee applies.

#drugpricing #walgreens

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