Good article from Fierce Healthcare and analysis from Kaiser Family Foundation on healthcare spending in Medicare households. Medicare households spend more on healthcare than other households. Health spending burden was twice as high.
Analysis by KFF: https://www.kff.org/medicare/issue-brief/medicare-households-spend-more-on-health-care-than-other-households/
#coverage #costs #medicare #medicareadvantage
While insurtechs overall have struggled, at least three – Alignment Healthcare, Devoted Health, and Clover Health – appear to be doing well. Clover Health had an adjusted EBITDA loss of $19.1 million in the fourth quarter and a full-year loss of $44.7 million last year. This is significantly better than in 2022. Its medical loss ratio (MLR) is projected to be just 81.2% for 2024. It expects adjusted EBITDA profit up to $20 million. Since it began, it, too, amassed a sizeable membership.
#clover #insurtechs
While insurtechs overall have struggled, at least three – Alignment Healthcare, Devoted Health, and Clover Health – appear to be doing well. Clover Health had an adjusted EBITDA loss of $19.1 million in the fourth quarter and a full-year loss of $44.7 million last year. This is significantly better than in 2022. Its medical loss ratio (MLR) is projected to be just 81.2% for 2024. It expects adjusted EBITDA profit up to $20 million. Since it began, it, too, amassed a sizeable membership.
#clover #insurtechs
At an unprecedented meeting, UnitedHealth Group CEO Andrew Witty heard from both Health and Human Services (HHS) Secretary Xavier Becerra and providers at a government sponsored meeting. The plea was for United to take responsibility for the Change Healthcare cyber attack and give additional financial support to providers.
In addition, HHS detailed more about what a $1.3 billion fund for cyber security would be used for. About 2,000 hospitals will receive incentive funds to adopt new cyber security practices. Another $153 million would go for various government initiatives.
Additional article: https://www.fiercehealthcare.com/providers/becerra-stakeholders-its-time-take-accountability-cybersecurity
#changehealthcare #unitedhealthcare #cyberattacks
The President announced his FFY 2025 budget even as all bills for the current FFY 2024 year have not been approved (including Health and Human Services spending). Biden did sign into law the bill that funds some agencies for the current fiscal year, including a partial retreat on a major Medicare doc cut. Because of the split in Congress, most of his proposals are dead on arrival but serve as campaign differentiators against his GOP opponent, former President Donald Trump.
In the FFY 2025 budget, Biden funds the commitments he made at the State of the Union and more:
Additional articles: https://www.modernhealthcare.com/politics-policy/biden-budget-cybersecurity-insurance-subsidies and https://insidehealthpolicy.com/health-insider/admin-releases-budget-addresses-fallout-over-change-healthcare-attack and https://www.fiercehealthcare.com/providers/congress-reaches-spending-deal-doc-pay-bump-delayed-dsh-cuts-and-more
(Some articles require a subscription.)
#budget2025 #healthcare #healthcarereform
President Joe Biden gave a fiery campaign speech at the State of the Union Thursday. He touched on policy changes he wants to see across government and society. In the healthcare world, he asked for significant additions to what he thinks is his successful record:
Additional articles: https://www.fiercehealthcare.com/payers/biden-call-drug-negotiation-expansions-stronger-reproductive-care-access-sotu and https://insidehealthpolicy.com/daily-news/biden-advocates-expansion-drug-price-controls-aca-state-union and https://www.modernhealthcare.com/politics-policy/joe-biden-state-union-sotu-2024
(Some articles may require a subscription.)
#biden #sotu #healthcare #healthcarereform #aca #obamacare #exchanges #drugpricing #ira #coveragegap #insulin
The Kaiser Family Foundation reports that almost 18 million initially lost coverage during Medicaid redeterminations. Some regained eligibility later. Most lost coverage on procedural grounds. Enrollment has dropped by about 10M so far in Medicaid nationwide.
#medicaid #redetermintations
Walgreens says that its road to financial recovery will be long – not a 12-month plan. It is undertaking a strategic review of its business. It plans to cut $1 billion in expenses this year.
Additional article: https://www.modernhealthcare.com/providers/walgreens-tim-wentworth-villagemd-shields-health-ownership
(Some articles may require a subscription.)
#walgreens
I am a big fan of Mark Cuban and what he and his Cost Plus Drugs are doing to reform the drug price system. So when he speaks, I listen. At a White House round table, Cuban proposed that federal programs cut off all ties to traditional pharmacy benefits managers (PBMs) and embrace full transparency. He has a direct-to-consumer firm and various transparent PBMs are all in on this idea.
The White House liked the transparency idea but knows it is easier said than done and there are many barriers to unravel what we have now. I note that the transparency model emerging right now works well for generic drugs, but it will be harder and take more time for brand drugs, especially until we get prices lower and solve for the shadowy rebate system.
But Cuban’s transparency and frankness is where the drug world needs to go. Cuban and advocates for reform also noted that at least some of the shortages we are seeing now are caused by the traditional opaque pricing and delivery channels. Cost Plus Drugs will begin manufacturing generics, targeting some with major supply issues. Hopefully Cuban’s radical approach gets people to think differently. PBMs need to reform. Brand drug makers have to embrace lower prices while safeguarding innovation. Direct-to-consumer models are the way to go.
Additional article: https://insidehealthpolicy.com/inside-drug-pricing-daily-news/biden-admin-urged-cut-ties-top-pbms-achieve-lower-drug-costs
(Some articles may require a subscription.)
#drugpricing #cuban #costplusdrugs #pbms #healthcarereform
A bipartisan spending bill has been agreed to by key lawmakers and will need to be voted on in each House. The package basically cuts in half the Medicare doc fix cut of 3.4%, pushes back scheduled disproportionate share hospital (DSH) payment cuts, and increases annual funding for community health centers. Accountable Care Organizations’ (ACOs) bonus program was also protected. Absent from the bill are major healthcare reforms. Docs are not very happy with the partial fix and no total overhaul of their rates.
Additional articles here: https://www.fiercehealthcare.com/providers/congress-reaches-spending-deal-doc-pay-bump-delayed-dsh-cuts-and-more and https://insidehealthpolicy.com/health-insider/lame-duck-battle-looms-health-wins-skinny-bill-expiring-december and https://insidehealthpolicy.com/daily-news/skinny-health-package-scales-back-doc-fix-adds-chc-funding and https://www.medpagetoday.com/practicemanagement/reimbursement/109008 and https://thehill.com/policy/healthcare/4507164-government-funding-bills-leave-out-phamacy-benefit-manager-industry-changes-as-white-house-mulls-reforms/
(Some articles may require a subscription.)
#governmentshutdown #healthcare
