Despite Conservatism, Vance Has Surprising Record On Healthcare
J.D. Vance is seen as a rightist Republican. But Donald Trump may have chosen a bit of a maverick on healthcare for his VP partner. In the past, Vance has criticized the Obamacare repeal because it would have impacted lower income people. In addition, he has signaled support on drug price reform, which is similar to Trump’s position. While he previously endorsed Medicare cuts, he has backed away from this position and has indicated that more should be spent on healthcare.
Additional article: https://insidehealthpolicy.com/daily-news/jd-vance-s-record-includes-drug-negotiation-support-mixed-record-medicare-abortion
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#election2024 #trump #vance
https://thehill.com/policy/healthcare/4775098-vance-healthcare-positions
UnitedHealth Reports Q2 Earnings
UnitedHealth Group reported that second-quarter net earnings declined 23% year-over-year to $4.2 billion. It reported revenue of $98.9 billion, a 6.5% increase from the prior year period. The medical loss ratio (MLR) was 85.1%, an increase from 83.2% a year ago. High Medicaid and Medicare Advantage (MA) medical expenses contributed to high costs in the second quarter. It also reported that anticipated Change Healthcare breach costs will be up to $2.45 billion in 2024.
Additional articles: https://www.fiercehealthcare.com/payers/unitedhealth-reaffirms-guidance-it-posts-42b-q2-profit and https://www.modernhealthcare.com/finance/unitedhealth-group-earnings-call-medicaid-medicare-advantage-change-healthcare-andrew-witty and https://www.beckerspayer.com/payer/unitedhealth-posts-4-2b-profit-in-q2.html
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#unitedhealthcare #earnings #medicaid #medicareadvantage
https://www.managedhealthcareexecutive.com/view/unitedhealth-revenue-grows-by-14-billion-in-2024
Advocacy Group Raises Alarm Bells On Part D
A new report from the Council for Affordable Health Coverage (CAHC) asks Congress to intervene on potential impacts from the Inflation Reduction Act (IRA) provisions on the Part D program. The group says that plan options have been diminished and premiums have soared. While I generally favor what the IRA did for drug prices overall, it does show the unintended impacts of policy not thought through. The soaring premiums and pullback for plans, especially standalone Part D (PDP) plans, are a result of new costs plans now bear – capping insulin costs, elimination of the 5% catastrophic phase cost-sharing for members, and passing through certain price concessions to pharmacies. Premiums went up this year for PDPs by an average of 21.5% (it is harder to determine for integrated Medicare Advantage Part D (MA-PD) plans). Premiums are expected to double in 2025 due to the $2,000 cap on out-of-pocket costs.
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#medicareadvantage #medicare #partd #pdp
Health Affairs Blog Endorses SDOH Investment Expansion
Interesting Health Affairs Forefront Blog on why social determinants of health (SDOH) investments are good for healthcare. Interesting fact: SDOHs contribute to upwards of 37 percent of the differences in geographic variation in Medicare. They argue we must reimburse for screening of SDOHs as well as spend to address the impacts. While I disagree with what is said, the conservative Manhattan Institute issued a report that opposes major healthcare investments in remediating SDOH impacts. That article is included too.
Additional article: https://insidehealthpolicy.com/daily-news/manhattan-institute-sdoh-initiatives-troubling-trend-health-care
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#sdohs #socialdeterminants #healthcare
https://www.healthaffairs.org/content/forefront/restructuring-medicare-payments-address-homelessness
CMS Releases Final Guidance On Medicare Smoothing Plan
The Centers for Medicare and Medicaid Services (CMS) released final guidance on the Medicare Prescription Payment Plan. The Inflation Reduction Act (IRA) included the ability for people to smooth or pay their drug cost-sharing over 12 months. CMS has been busy laying out requirements and health plans and pharmacy benefits managers (PBMs) implementing outreach, education, and systems.
I have been critical of too much too fast on this front. The investment has been huge to set up the program and I fear it will not have major uptake for many reasons – complexity, senior behavior and suspicion, recent reductions of costs in other areas. As well, the regulations from CMS seem half-hearted and do not force major adoption (e.g., no PA-based outreach and initial outreach that is too limited). I guess if you are going to do this, do it right. Too, there is the fear that people will not pay their monthly cost-sharing to the plan. This could impact plan financials.
#cms #partd #pdp #medicareadvantage #drugpricing
— Marc S. Ryan
