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December 20, 2023

December 20, 2023 No Comments

Feds Expect 19M On Exchanges Based on current enrollments on the Exchanges, the feds say enrollment will break a record with 19 million in 2024.  Up from 16.4 million in 2023.  This is driven by the extension of the enhanced premium subsidies and other investments in outreach and marketing. Additional articles here: https://insidehealthpolicy.com/daily-news/admin-least-19m-enrolled-aca-plans-nationwide-nov-1 and https://thehill.com/policy/healthcare/4369743-white-house-touts-record-breaking-obamacare-enrollment/ CMS release here: https://www.cms.gov/newsroom/press-releases/healthcaregov-enrollment-exceeds-15-million-surpassing-previous-years-milestones (Some articles may require a subscription.) #aca #obamacare #exchanges #coverage Link to Article Health Equity A Top Goal in 2024 More than 80% of executives from healthcare and life sciences organizations say health equity is a top-10 goal for 2024. #healthequity #healthinsurance Link to Article Hospital At Home Program Interesting interview on prospects of hospital-at-home extension and growth. There are a number of good pilots in several lines of business that show great promise. (Article may require a subscription.) #hospitals #hospitalathome Link to Article Conflicting Reports on ACO Success This study

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December 19, 2023

December 19, 2023 No Comments

New Antitrust Merger Guidelines The Federal Trade Commission (FTC) and the Department of Justice (DOJ) finalized new guidelines for mergers and acquisitions. They are not legally binding.  Each deal would receive an assessment based on the uniqueness of the parties and merger. The guidelines give health plans, hospitals, and others in healthcare a look into the decision-making process to determine consistency with antitrust rules. The guidelines and greater scrutiny fulfill a Biden administration pledge and come from an executive order.  FTC release here: https://www.ftc.gov/news-events/news/press-releases/2023/12/federal-trade-commission-justice-department-release-2023-merger-guidelines . Additional article here: https://www.healthcaredive.com/news/ftc-doj-final-merger-guidelines-healthcare/702897/ At the same time, two hospital entities called off their merger after challenges from the FTC and state of California regulators: https://www.fiercehealthcare.com/providers/john-muir-health-tenet-healthcare-nix-143m-hospital-deal-after-regulatory-pushback Overall, the scrutiny is good, especially on provider proposals, as most mergers lead to higher costs. #ftc #doj #mergers #acquisitions #antitrust #hospitals #healthplans Link to Article DOJ Seeks To Stall RADV Lawsuit The Department of Justice (DOJ) is urging

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December 18, 2023

December 18, 2023 No Comments

More “Retail Meets Healthcare” Investments Kroger is piloting value-based primary care clinics like many other retailers. The grocery chain will team up with Better Health Group, a provider network, to build out primary care centers.  Kroger in-store clinics will be replaced. There is a senior focus. Walgreens is pulling back on its clinic investments.  So, retail healthcare is not without its risks but will continue to grow. #retailhealthcare #kroger Link to Article Molina Reduces Bright Payment for Medicare Advantage Business After diligence, Molina Healthcare will cut how much it will pay for Bright Health Group’s California Medicare Advantage plans to $425 million, from $600 million. Molina did not specify in a news release Monday why it reduced the agreed-upon purchase price by 16.7% from $600 million gross/$510 million net.  This is more bad news for the insurtech world, which has seen stunning reversals.  (Article may require a subscription.) #brighthealth #molina

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