Optum Announces Transparent-Like Pharmacy Model
Pressured by the rise of transparent pricing models, Optum Rx has announced its own approach to greater transparency. I would call it transparency-like. It is offering a single per member cost, encompassing retail, home delivery, specialty drug and rebate components.
#transparency #pbms #optumrx
https://www.fiercehealthcare.com/payers/optum-rx-puts-emphasis-predictability-new-pricing-model
Health Plan CEO Compensation
Fierce Healthcare assembles the top 5 in terms of health plan compensation in 2023.
#healthplans
Government To Fund $50 Million For Cybersecurity
The Department of Health and Human Services’ (HHS’) research funding agency will provide more than $50 million to developers who can build a scalable cybersecurity platform to protect hospitals for cyberattacks.
Additional articles: https://www.modernhealthcare.com/cybersecurity/hhs-arpa-h-hospital-cyberattacks-unitedhealth-change-healthcare-ascension and https://www.healthcaredive.com/news/healthcare-cybersecurity-arpa-h-upgrade-program/716609/ and https://www.healthcareitnews.com/news/hhs-offers-50m-help-providers-patch-ransomware-vulnerabilities
(Some articles may require a subscription.)
#cyberattacks #healthcare
Senate Finance Joins HELP Committee In Wanting To Reform Medicare Doc Pay
The Senate Finance Committee joins the HELP Committee in wanting to fix the Medicare physician payment dilemma.
Additional articles: https://www.modernhealthcare.com/politics-policy/medicare-physician-pay-reform-proposals-senate-bill-cassidy-ron-wyden and https://insidehealthpolicy.com/daily-news/senate-finance-leaders-unveil-potential-medicare-physician-pay-reforms-telehealth
(Some articles may require a subscription.)
#medicare #physicians #reimbursement
https://www.healthcaredive.com/news/senate-finance-committee-medicare-doctor-pay-reform/716555
Steward Is Progressing In Sale Of Assets
Steward Health Care is seeing interest from potential buyers of its hospitals in multiple states. It, too, is in advanced discussions with Optum on its provider group.
Additional article: https://www.modernhealthcare.com/legal/steward-health-care-bankruptcy-hospital-asset-sale-timeline
(Some articles may require a subscription.)
#healthcare #hospitals
https://www.healthcaredive.com/news/steward-lays-out-timeline-asset-sales-bankruptcy/716560
Telehealth Extension Advances
The House Energy & Commerce health subcommittee advanced an extension for telehealth for two years.
(Article may require a subscription.)
#telehealth #healthcare
New Study Critical Of FTC Oversite Of Pharmaceutical Industry
A new study finds that the Federal Trade Commission (FTC) pursued very few challenges to mergers or enforcement actions of the pharmaceutical industry over the last two decades. From 2000 to 2022, the FTC initiated or completed just 85 actions in the pharmaceutical sector, including 62 challenges of mergers, 22 enforcement actions against allegedly unlawful business practices, and one rule related to pharmaceuticals. It allowed 61 of 62 mergers, but some drug divestitures did occur in mergers. The study finds a poor track record overall. This finding comes as the Biden administration is ramping up scrutiny of consolidations in healthcare.
(Article may require a subscription.)
#ftc #healthcare #mergers #acquisitions #manda #antitrust
https://www.medpagetoday.com/washington-watch/washington-watch/110224
Becker’s Reviews Medicare Advantage Issues
Becker’s reviews Medicare Advantage (MA) in a slightly pro-provider way but it is not terrible. It finds that providers are terminating MA plan contracts as well as setting up their own plans. It discusses the status of the new prior authorization rule. It notes MA plans have financial headwinds and will cut back benefits. It also raises issues with supplemental benefits, overpayments, and the future of fee-for-service (FFS).
#medicareadvantage #medicare #hospitals
https://www.beckerspayer.com/payer/10-key-questions-facing-medicare-advantage.html
— Marc S. Ryan
