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June 14, 2024

New Study Suggest FTC Scrutiny Of Hospital Mergers Is Meager

A new study says the Federal Trade Commission’s (FTC) scrutiny of mergers is low and mergers lead to increased prices. Part of the issue is low funding for the FTC.

(Article may require a subscription.)

#ftc #manda #mergers #acquisitions #hospitals

https://www.modernhealthcare.com/mergers-acquisitions/antitrust-enforcement-falls-short-hospital-mergers-study

More On 2024 MA Star Recalculations

Additional articles on the Centers for Medicare and Medicaid Services (CMS) decision to recalculate Star scores for 2024 and reopen bids for those who received higher scores. Reports suggest 76 contracts with 44 health insurers would gain at least 0.5 Stars. This could mean an additional $1 billion in revenue to plans, which goes out to members in added benefits. Some big plans receive additional dollars.

Additional article: https://www.fiercehealthcare.com/payers/report-medicare-advantage-quality-ratings-get-new-calculations

#medicareadvantage #stars #cms

https://www.healthcaredive.com/news/cms-recalculates-medicare-advantage-star-ratings/718967

Are Lawmakers Serious On Stabilizing Medicare?

Members on each side of the aisle on the House Budget Committee said they were ready to tackle Medicare solvency.  But there are few concrete proposals, except for a premium support model from a GOP caucus.

#medicare #solvency

https://www.healthcaredive.com/news/medicare-solvency-house-budget-committee/718907

House Committee Questions Medicare Pilots

A House subcommittee is questioning the viability of many Medicare pilots created by the innovation office.  While the innovation office defended the number of pilots saying it learns from each one, it is clear the number is out of control, creating confusion, overlap, and administrative expense.

#medicare #healthcarereform #cms

https://www.healthcaredive.com/news/cmmi-cms-innovation-center-federal-spending-house-energy-commerce/718926

Sanders Drops Subpoena After Drug Executive Agrees To Appear

Senate HELP Committee Chairman Bernie Sanders, I-VT, agreed to drop issuing a subpoena after the leader of Novo Nordisk agreed to appear before Congress. Sanders wants to interrogate the high cost of weight-loss drugs compared with other developed nations.

#drugpricing #branddrugmakers #weightlossdrugs

https://thehill.com/policy/healthcare/4722401-sanders-drops-subpoena-effort-novo-nordisk-ceo-agrees-testify

PhRMA Analysis Suggests Public Funding Should Not Enter Into Drug Price Negotiations

A Health Affairs Forefront blog argues that it is too difficult and complex to factor public funding into drug negotiation equations and that the public expects a societal return on such investment anyway.  It would be easier to side with this argument if American drug prices were reasonable and not many folds higher than other developed countries.

(Article may require a subscription.)

#drugpricing #ira #branddrugmakers

https://www.healthaffairs.org/content/forefront/federal-support-should-not-factor-determining-pharmaceutical-prices-under-ira

AHIP Session Shines Light On Private Equity Investments

While private equity (PE) firms argue they benefit the healthcare ecosystem, an AHIP conference session focused on the deleterious impact. About 8% of all private hospitals and 22% of for-profit ones are owned by PE firms. In addition, PE has purchased many specialty practices. Some of the findings on PE-owned hospitals:

  • Margins increased
  • Charges went up for both hospitals and physicians owned by the health system
  • Adverse events and mortality increased

#hospitals #privateequityfirms #providers

https://www.managedhealthcareexecutive.com/view/harm-not-help-private-equity-s-influence-on-u-s-healthcare-ahip-2024

KFF Analysis Discusses Site-Neutral Payments

I am an advocate for far-reaching implementation of site-neutral payments.  It is critical to reducing overall healthcare costs and lowering patients’ exorbitant out-of-pocket costs.  The Kaiser Family Foundation (KFF) has a good and balanced review of site neutrality, including how certain healthcare assets might be protected. I likely will do a blog on this in the near future.

#hospitals #medicare #siteneutral

https://www.kff.org/medicare/issue-brief/five-things-to-know-about-medicare-site-neutral-payment-reforms/

— Marc S. Ryan

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