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December 12, 2023

A Rare Occurrence For Healthcare Costs In a rare occurrence, medical service costs at hospitals increased 2% in the first three quarters of 2023. This is about the 1.9% that the economy grew. Generally, hospital costs tend to far exceed economic growth and inflation. The report is from Turquoise, a new price transparency startup.  The findings also show that costs can vary across regions/markets as well as within markets. #pricetransparency #healthcare Link to Article At The Same Time, Overall Healthcare Costs Rising Advisory firm WTW surveyed 266 insurers across 66 countries and found that 58% are bracing for “higher or significantly higher” healthcare cost increases in the three upcoming years. Global costs increased by 10.7% in 2023, up from a 7.4% increase in 2022. The average cost trend insurers expect is 9.9% next year. #healthcare #healthinsurance Link to Article Excellent Pro Publica Analysis of Waste and Abuse in Medicare Latest estimates

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December 11, 2023

Cigna-Humana Merger Off — For Now The Cigna-Humana merger is reportedly off as the entities could not arrive at financial terms. This leaves Cigna with two big decisions: (1) What smaller deals will they enter into? and (2) Will they sell their Medicare Advantage (MA) business? While MA is a smaller portfolio than many big plans have, if it can improve its Star scores and make additional investments, it could still be lucrative for Cigna. On the other hand, Cigna may be investing most of its efforts in its non-margin-limiting Evernorth services subsidiary. Additional articles: https://www.modernhealthcare.com/mergers-acquisitions/cigna-humana-merger-deal-scrapped-stock-buyback and https://www.healthcaredive.com/news/cigna-humana-deal-falls-through-wall-street-journal/702091/ and https://thehill.com/policy/healthcare/4353008-cigna-ends-plans-to-merge-with-humana-report/ (Some articles may require a subscription.) #healthplans #mergers #acquisitions #cigna #humana Link to Article Bill Would Reform PBMs And Introduce Site-Neutral Payments in Medicare I reported on this last week, but another good article describing a large House bill that would bring some transparency to PBMs and start site-neutral policies

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December 8, 2023

New Poll On Affordable Care Act And Healthcare Issues A new poll shows that the American public favors maintaining the Affordable Care Act and reforming the current healthcare system. My blog Monday will build on my December 7 blog and go deep into this poll. #healthcare #healthcarereform #affordableuniversalaccess #universalaccess Link to Article House May Cancel Physician Medicare Rate Cut A bipartisan group of representatives has introduced a bill in the House that would cancel the 2024 Medicare physician pay cut finalized last month by the Biden administration. Physicians are always on a roller coaster when it comes to rates in Medicare. I think the formula has to be revisited broadly. The House committee bill would only restore 2.5% of the 3.4% cut: https://insidehealthpolicy.com/daily-news/house-ec-bill-would-erase-only-25-physician-fee-cuts-matching-senate (Some articles may require a subscription.) #providers #physicians #rates Link to Article Bipartisan Effort Looking At Healthcare Entity Ownership And Anti-Competitive Behavior Must-read article about efforts by the

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December 7, 2023

United Health Foundation Says Chronic Conditions Rising The United Health Foundation released a study that concludes chronic conditions are rising in the U.S. It also released its annual “America’s Health Rankings” report, which tracks health across the country based on 87 measures and 28 data sources. United finds that persons with multiple chronic conditions has reached their highest levels since they were first tracked. Mental health and diabetes have risen.  It also found health condition disparities exist for asthma, COPD, and diabetes. United also found that more people have multiple co-morbidities. United calls for investments in care management as well as health equity. As I note in my book, The Healthcare Labyrinth (available on this website), one of America’s key problems is a lack of investment in health, wellness, and care management.  Other developed nations concentrate resources here and have much better outcomes, fewer people with disease states and conditions,

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