May 30, 2024

Big Blue Highmark Sees Bad Trends in Medicare Advantage

Pennsylvania-based Big Blue Highmark Health says it is seeing the same sort of Medicare Advantage (MA) trends other plans have reported. It sees increased utilization across inpatient and outpatient as well as rising costs of GLP-1 drugs.

#highmark #medicareadvantage #weightlossdrugs


What Would GOP And Trump Healthcare Agenda Look Like?

Many are readying for a new Trump administration and looking at what healthcare policy changes could occur.  Many say that the GOP will not go for a full repeal of the Affordable Care Act (ACA), but that enhanced subsidies will die at the end of 2025. The GOP might not fully repeal Medicare drug negotiations, but tweak the law.  Trump, too, could revive international reference pricing in Part B and perhaps in Part D. This is where Trump and Biden look a lot alike. The biggest changes could come with Medicaid, including a master overhaul of the program and more work requirements.

In related news, community health centers and their patients have been hurt phenomenally by Medicaid unwinding.

Additional articles: https://kffhealthnews.org/news/article/obamacare-subsidies-presidential-election/ and https://kffhealthnews.org/news/article/safety-net-health-clinics-cut-services-staff-medicaid-unwinding/

#trump #healthcare #aca #exchanges #obamacare #medicaid #drugprices #ira


Wyden Wants Broad Investigation of United Healthcare Over Cyberattack

Sen. Ron Wyden, Chairman of the Finance Committee (which has cognizance over healthcare policy), wants the federal government to investigate United Healthcare for negligent security related to the Change Healthcare cyberattack.

(Article may require a subscription.)

#changehealthcare #cyberattacks


Merger and Acquisition Deals May Face Greater Due Diligence

A good article that discusses the Change Healthcare cyberattack and the Biden administration’s new focus on consolidations in healthcare.  Predictions are that deals will still be proposed but face additional due diligence.

(Article may require a subscription.)

#manda #ftc #mergers #acquisitions #healthcare


DOJ Challenging Steward Bankruptcy Plan

The Justice Department is challenging Steward Health Care’s proposed bankruptcy plan, arguing it needs more time to review possible sales of assets for competitiveness reasons, especially Optum’s acquisition of a provider group.

Additional article: https://www.modernhealthcare.com/legal/steward-health-care-bankruptcy-review-doj-optum

(Some articles may require a subscription.)

#steward #optum #healthcare #manda #mergers #acquisitions


— Marc S. Ryan

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