May 24, 2024

Nursing Homes Sue On Staffing Ratios

Nursing home associations are suing in federal court to overturn a new staffing ratio rule. The rule will lead to a massive consolidation in the industry and the loss of independent homes.

Additional articles: https://www.modernhealthcare.com/providers/nursing-home-staffing-mandate-ahca-lawsuit and https://insidehealthpolicy.com/daily-news/nursing-homes-sue-cms-over-staffing-rule-aarp-backs-agency

(Some articles may require a subscription.)

#nursinghomes #staffing


More Layoffs At Highmark

Highmark Health, a PA-based Blue, is undergoing a third round of layoffs.

Additional article: https://www.modernhealthcare.com/labor/highmark-health-layoffs-engen

(Some articles may require a subscription.)

#healthcare #healthplans #layoffs


House Budget Committee Rallies Around Consolidation Scrutiny And Site-Neutral Policies

The House Budget Committee seems to have a bipartisan consensus on reining in hospital consolidations and mergers. As well, there seems to be consensus on the need to enact site-neutral payments.  Hospitals will vigorously object and try to torpedo any bill. A bill to begin such policies passed the House but did not in the Senate.

#hospitals #consolidations #mergers #manda #antitrust #siteneutral


Good Survey On Healthcare Vulnerability To Cyberattacks

A new survey shows how vulnerable healthcare is to cyberattack and the need for federal intervention and planning. Thirty-seven percent of healthcare organizations did not have a cyberattack contingency plan despite half of them having experienced an attack.

#cyberattacks #healthcare


Smaller PBMs Argue ESI’s Transparent-Like Pricing Relies On Spread-Pricing

A group of smaller plans is arguing that Express Scripts supposed transparent pricing relies on old models, such as spread-pricing. That is why I characterized it yesterday and today as transparent-like.

(Article may require a subscription.)

#pbms #transparency #drugpricing


HHS OCR Fails To Clarify Change Notification While Affirming All Could Be Responsible For Breach Notifications

The Health and Human Services’ Office of Civil Rights has reaffirmed that business associates of covered entities may also be responsible for breach notifications.  At the same time, providers are clamoring to understand who will be responsible for reporting the Change Healthcare breach.

(Article may require a subscription.)

#changehealthcare #cyberattacks


Ozempic Shown To Help Reduce Major Kidney Events

A Phase 3 trial is shown to reduce major kidney events and cardiovascular deaths for those with diabetes and chronic kidney disease. Brand drug makers are busy qualifying GLP-1s for more disease states, which will drive utilization and overall spending of these very expensive drugs.

Additional article: https://www.medpagetoday.com/endocrinology/diabetes/110310 and https://www.beckershospitalreview.com/glp-1s/ozempic-quells-kidney-disease-risk-study-finds.html

#weightlossdrugs #drugpricing #branddrugmakers


Health Alliance Plan Drives Biosimilars

Great article on how Health Alliance Plan has driven adoption of biosimilars and provider buy-in.  Around four in 10 Health Alliance members are prescribed biosimilar versions of Humira.

#biosimilars #drugpricing #branddrugmakers


Some MA Plans Are Embracing Change With Lower Rates

A good article about the division within Medicare Advantage (MA) plans on what to make of the MA rate cuts.  Some are embracing it as a way of innovating.

#medicareadvantage #healthplans #rates


Sanders Argues U.S. Has Dental Crisis

Senate HELP Chairman Bernie Sanders says there is a growing U.S. dental crisis and has introduced legislation to tackle it.

#sanders #healthcare #dentalcare


— Marc S. Ryan

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