Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Trump’s nominee to run Medicare and Medicaid advances

The Associated Press reports: President Donald Trump’s nominee to run Medicare and Medicaid won committee approval Thursday, clearing her for a final floor vote in the Senate.

AP via The Washington Post, March 2, 2017

Faring Better Than Many ACA Insurers, Molina Backs Health Law ‘Tuneup’

Kaiser Health News reports: Some large health insurance companies have suffered losses under the Affordable Care Act, leading to a few high-profile exits from the online marketplaces. Humana is just the latest, announcing in January that it will stop offering health insurance on the ACA health exchanges at year’s end.

Kaiser Health News,  March 2, 2017

High-Risk Pools Another Sticking Point Among Republicans

Morning Consult reports: Sen. Rand Paul on Wednesday expressed opposition to House GOP leaders’ plan to cover people with pre-existing conditions, highlighting another division that Republicans must overcome to repeal the Affordable Care Act.

Morning Consult, March 1, 2017

Insurers pay twice as much as hospitals for hip and knee implants

Stat News reports: Imagine this: You go to buy a car, but you don’t know who makes it, how other customers feel it’s performing, or how its price compares to other cars in its class.

Stat New, February 28, 2017

Hospitals, Both Rural And Urban, Dread Losing Ground With Health Law Repeal

Kaiser Health News reports: More than a year ago, she lost her job at a nearby rural hospital after it closed and, as Republicans work to dismantle the Affordable Care Act, wonders whether she’ll soon be out of work again.

Kaiser Health News, February 28, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

CMS nominee breezes through confirmation hearing

The Hill reports: President Trump's pick to lead the Center for Medicaid and Medicare Services (CMS) cruised through her confirmation hearing Thursday, though Democrats showed frustration at her refusal to offer specifics.

The Hill

Thursday, February 16, 2017

The IRS Has Just Made Obamacare’s Individual Mandate Optional

The Fiscal Times reports: When President Trump signed an executive order shortly after taking office designed to weaken the Affordable Care Act, some questioned whether the instructions to federal agencies to look for ways to ease the law’s burden on businesses and individuals would have any real bite.

The Fiscal Times

Wednesday, February 15, 2017

Amid Obamacare uncertainty, insurance giant Humana plans to leave marketplaces in 2018

Los Angeles Times reports: Humana Inc., one of the nation’s largest health insurers, will stop selling Obamacare health plans next year, the company announced Tuesday. The move threatens to rattle jittery insurance markets and further complicate Republicans’ push to repeal and replace the Affordable Care Act.

LA Times

Tuesday, February 14, 2017

Aetna, Humana end $34 billion merger agreement

CNBC reports: Aetna and rival Humana are terminating their merger, after their $34 billion deal was blocked by a federal court on antitrust grounds. Aetna will pay Humana a $1 billion break-up fee, in accordance with the agreement.

CNBC

Tuesday, February 14, 2017

Drugmaker Marathon ‘Pausing’ Delivery Of $89,000-A-Year Muscular Dystrophy Drug

Kaiser Health News reports: In a surprise move Monday, Marathon Pharmaceuticals told patient advocates that it would “pause” the launch of its drug Emflaza because of pricing concerns expressed by patients and advocacy groups.

Kaiser Health News

Monday, February 13, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Tom Price Is Confirmed as Health Secretary

The New York Times reports: The Senate early Friday approved the nomination of Representative Tom Price to be secretary of health and human services, putting him in charge of President Trump’s efforts to dismantle the Affordable Care Act.

The New York Times

Friday, February 10, 2017

Obama’s Drug Czar: The Opioid Crisis Must Continue To Be A Federal Priority

Kaiser Health News reports: The GOP is working to repeal and replace the 2010 health law, known for insuring more than 20 million people. And the change could affect another health concern: the nation’s opioid abuse problem.

Kaiser Health News

Thursday, February 9, 2017

Judge, Citing Harm To Customers, Blocks $48 Billion Anthem-Cigna Merger

The New York Times reports: The ruling, by Judge Amy Berman Jackson of the Federal District Court for the District of Columbia, came two weeks after another federal judge blocked a proposed $37 billion merger between Aetna and Humana on antitrust grounds. Judge Jackson wrote in her order that she found the Justice Department’s arguments against the deal persuasive, and that putting Anthem and Cigna together would harm customers.

NY Times

Thursday, February 9, 2017

How Would Republican Plans for Medicaid Block Grants Actually Work?

The New York Times reports: There are only so many ways to cut Medicaid spending. You can reduce the number of people covered. You can reduce the benefit coverage. You can also pay less for those benefits and get doctors and hospitals to accept less in reimbursement. Or you can ask beneficiaries to pay more.

NY Times

Monday, February 6, 2017

Trump Says Health Law Replacement May Not Be Ready Until Next Year

The New York Times reports: President Trump said in an interview that aired on Sunday that a replacement health care law was not likely to be ready until either the end of this year or in 2018, a major shift from promises by both him and Republican leaders to repeal and replace the law as soon as possible.

NY Times

Sunday, February 5, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Repeal Ripples: Five Obamacare Exchange Chiefs Contemplate An Uncertain Future

Kaiser Health News reports: The health insurance marketplaces created by the Affordable Care Act are in their third year of selling health insurance plans to people who don’t get insurance through work.

Kaiser Health News, January 27, 2017

Senators' ObamaCare replacement bills highlight GOP divide

The Hill reports: As House and Senate Republicans unveiled an aggressive plan to repeal and replace the Affordable Care Act within the next three months, disagreement over two Senate bills introduced this week shows the stark divide within the party over a way forward.

The Hill, January 26, 2017

What President Trump's executive order means for hospitals & physicians: 14 key thoughts

Becker's Hospital Review reports: President Donald Trump signed an executive order on Jan. 20 to reduce the economic burden of the ACA. Fourteen academics and leaders of healthcare companies and hospitals discuss the executive order's implications on hospitals and physicians.

Becker's Hospital Review, January 24, 2017

Judge blocks major health insurance merger

Politico reports: A federal judge has blocked Aetna’s merger with Humana after finding that the health insurers’ $37 billion deal would leave seniors with fewer and costlier options for private Medicare coverage.

Politico, January 23, 2017

Lingering FTC concerns could stall $9.4B Walgreens-Rite Aid merger

Becker's Hospital Review reports: With the deadline fast approaching to close the merger between Deerfield, Ill.-based Walgreens Boots Alliance and Camp Hill, Pa.-based Rite Aid, Federal Trade Commission lawyers still have concerns about the transaction, people familiar with the matter told Bloomberg.

Becker's Hospital Review, January 23, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Trump’s Nominee For Agriculture Has Key Health Role

Kaiser Health News reports: Amid the cacophony of confirmation hearings for Cabinet nominees, President-elect Donald Trump reportedly has settled on former Georgia Gov. Sonny Perdue to fill the final Cabinet-department vacancy: Secretary of Agriculture. Although consumers may simply think of the Department of Agriculture (USDA) as responsible for overseeing the farming industry, it also plays a key role in promoting health.

Kaiser Health News

Friday, January 20, 2017

How Large Employer Health Plans Could Be Affected By Obamacare Overhaul

NPR reports: If you think that you wouldn't be touched by a Republican overhaul of Obamacare because you get health insurance through your job at a big company, think again.

NPR

Thursday, January 19, 2017

Anthem aims for 30% reduction in number of opioid prescriptions by 2019

Becker's Hospital Review reports: Indianapolis-based Anthem said it wants to reduce the amount of opioids prescribed to policyholders by 30 percent by the end of 2019. The insurer said in a Wednesday news release it is also committed to helping its affiliated health plans double the number of consumers who receive counseling as part of medication-assisted therapy for opioid addiction.

Becker's Hospital Review

Thursday, January 19, 2017

Health Law Repeal Could Cost 18 Million Their Insurance, Study Finds

The New York Times reports: Eighteen million people could lose their insurance within a year and individual insurance premiums would shoot upward if Congress repealed major provisions of the Affordable Care Act while leaving other parts in place, the nonpartisan Congressional Budget Office said on Tuesday.

NY Times

Wednesday, January 18, 2017

Drugmakers Manipulate Orphan Drug Rules To Create Prized Monopolies

Kaiser Health News reports: More than 30 years ago, Congress overwhelmingly passed a landmark health bill aimed at motivating pharmaceutical companies to develop new drugs for people whose rare diseases had been ignored. By the drugmakers’ calculations, the markets for such diseases weren’t big enough to bother with.

Kaiser Health News

Tuesday, January 17, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

U.S. House Republicans to vote on Obamacare repeal

Reuters reports: U.S. House Republicans moved ahead on Friday with legislation aimed at dismantling Obamacare, despite concerns about not having a replacement for the healthcare program and the potential financial cost of repealing President Barack Obama's landmark law.

Reuters

Friday, January 13, 2017

Trump’s HHS Nominee Got A Sweetheart Deal From A Foreign Biotech Firm

Kaiser Health News reports: When tiny Australian biotech firm Innate Immunotherapeutics needed to raise money last summer, it didn’t issue stock on the open market. Instead, it offered a sweetheart deal to “sophisticated U.S. investors,” company documents show.

Kaiser Health News

Friday, January 13, 2017

CVS slashes price of substitute EpiPen auto-injectors to $109.99

Stat News reports: CVS Health announced Thursday morning that it has cut the price of two-packs of epinephrine auto-injectors to $109.99 — roughly the price that brand-name EpiPen shots were selling for eight years ago, before their escalating price became a hot political issue.

Stat News

Thursday, January 12, 2017

Sylvia Burwell urges need for Medicare to have drug price negotiating power

Healthcare Finance News reports: Giving Medicare authority to negotiate drug prices is the best way to keep those spiraling costs under control for the program's recipients, departing Health and Human Services Secretary Sylvia Burwell said Monday.

Healthcare Finance News

Tuesday, January 10, 2017

UnitedHealth Group to Buy Outpatient Surgery Chain for $2.3 Billion

The New York Times reports: UnitedHealth Group, one of the largest and most diversified health insurance companies in the United States, said on Monday that it planned to buy Surgical Care Affiliates, a chain of outpatient surgery centers, for about $2.3 billion. The deal is expected to close in the first half of 2017.

NY Times

Monday, January 9, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Walgreens CEO: Obamacare Replacement Shouldn't Be To 'Detriment' Of U.S.

Forbes reports: Whatever the Republican Congress and Donald Trump's White House create to replace the Affordable Care Act, Walgreens Boots Alliance hopes it “will not be to the detriment of [U.S.] citizens,” the company’s top executive said Thursday.

Forbes

Friday, January 6, 2017

Only 20 Percent Of Americans Support Health Law Repeal Without Replacement Plan

Kaiser Health News reports: The Republican strategy of repealing the Affordable Health Care Act before devising a replacement plan has the support of only one in five Americans, a poll released Friday finds.

Kaiser Health News

Friday, January 6, 2017

Medicare Failed To Recover Up To $125 Million In Overpayments, Records Show

Kaiser Health News reports: Six years ago, federal health officials were confident they could save taxpayers hundreds of millions of dollars annually by auditing private Medicare Advantage insurance plans that allegedly overcharged the government for medical services.

Kaiser Health News

Friday, January 6, 2017

Ryan Says Obamacare Replacement Bill Will Be Done in 2017

Morning Consult reports: House Speaker Paul Ryan says legislative work on repealing and replacing the Affordable Care Act will be completed this year, but exactly when the transition takes place on insurance exchanges is still to be determined.

Morning Consult

Thursday, January 5, 2017

Commonwealth Fund study finds parallels in uninsured rate decline, other economic gains and ACA implementation

Healthcare Finance News reports: The vast majority of adults who enrolled for health insurance during the first open enrollment period would likely not have held coverage without the Affordable Care Act expansions, finds a new study from the Commonwealth Fund.

Healthcare Finance News

Thursday, January 5, 2017

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members. 

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

Medicare Penalizes Hospitals In Crackdown On Antibiotic-Resistant Infections

NPR reports: The federal government has cut payments to 769 hospitals with high rates of patient injuries, for the first time counting the spread of antibiotic-resistant germs in assessing penalties.

NPR
Thursday, December 22, 2016

Cleveland Clinic CEO Toby Cosgrove named as contender for Trump's VA pick

Modern Healthcare reports: Cleveland Clinic CEO Dr. Toby Cosgrove was among prospective cabinet picks who met with President-elect Donald Trump on Tuesday. Cosgrove is reportedly a contender to lead the Veterans Affairs Department.

Modern Healthcare
Wednesday, December 21, 2016

Senate report shows Martin Shkreli is just as bad as you think he is

USA Today reports: Staggering hikes — in some cases higher than 5000%— in prices of prescription drugs threaten the health and economic stability of Americans who can't afford vital medicines, a congressional report warned Wednesday.

USA Today

Wednesday, December 21, 2016

Health Exchange Enrollment Jumps, Even as G.O.P. Pledges Repeal

The New York Times reports: About 6.4 million people have signed up for health insurance next year under the Affordable Care Act, the Obama administration said Wednesday, as people rushed to purchase plans regardless of Republican promises that the law will be repealed within months.

The New York Times
Wednesday, December 21, 2016

Women Doctors May Be Better For Patients’ Health

Kaiser Health News reports: When a patient goes to the best hospital, he or she usually hopes for a doctor who is knowledgeable and experienced. Something else to wish for? A woman physician.

Kaiser Health News
Monday, December 19, 2016

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

 Feds Extend Healthcare.Gov Deadline To Dec. 19, Citing Late Rush

USA Today reports: Federal regulators Thursday night extended the midnight deadline for Affordable Care Act insurance by four days, as consumers fought to get through to call center operators and log onto Healthcare.gov to buy insurance that takes effect Jan. 1.

USA Today, December 16, 2016

G.O.P. Plans to Replace Health Care Law With ‘Universal Access’

The New York Times reports: House Republicans, responding to criticism that repealing the Affordable Care Act would leave millions without health insurance, said on Thursday that their goal in replacing President Obama’s health law was to guarantee “universal access” to health care and coverage, not necessarily to ensure that everyone actually has insurance.

The New York Times, December 16, 2016

 

CMS debuts new ACO model for dual-eligibles

The federal government has introduced a new accountable care organization model aimed at working with states to provide better quality, lower cost care for people enrolled in both Medicare and Medicaid.

Fierce Healthcare, December 15, 2016

Obama administration blocks states from cutting off grants to Planned Parenthood

The Washington Post reports: The Obama administration took steps Wednesday to block states from cutting off federal family planning grants to Planned Parenthood, finalizing a rule that is to take effect just days before the inauguration of President-elect Donald Trump.

The Washington Post, December 14, 2016

Aetna CEO takes stand to defend deal with Humana

In his turn on the witness stand in the Aetna-Humana antitrust trial, Aetna CEO Mark Bertolini sparred with Justice Department lawyers about the central debates surrounding the acquisition—including whether the deal will deliver on its promised efficiencies.

Fierce Healthcare, December 13, 2016

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

By Claire Thayer, December 9, 2016

Every business day, MCOL posts feature stories making news on the business of health care. Here are five we think are particularly important for this week:

1. 5 quick ways a new HHS secretary could change health policy
Kaiser Health News reports: Prospective Health and Human Services secretary Tom Price, currently the chairman of the House Budget Committee, brings a distinctive to-do list to the agency. And, if confirmed by the Senate, he will have tremendous independent power to get things done.
Kaiser Health News via the Washington Post, December 9, 2016

2. HHS Chief Warns Senate Democrats of ‘Chaos’ Under ACA Repeal
Morning Consult reports: The nation’s top health official spoke with Senate Democrats Thursday about the repeal of the Affordable Care Act, warning that undoing the law without having a replacement ready could be disastrous.
Morning Consult, December 8, 2016

3. These drug price hikes cost taxpayers millions
Stat News reports: Drugs to treat cancer, high blood pressure, and seizures experienced large price spikes in 2015, costing taxpayers millions of dollars in added Medicare spending, according to new data released by the federal Centers for Medicare and Medicaid Services.
StatNews, December 8, 2016

4. Health Insurers List Demands if Affordable Care Act Is Killed
The NY Times reports: The nation’s health insurers, resigned to the idea that Republicans will repeal the Affordable Care Act, on Tuesday publicly outlined for the first time what the industry wants to stay in the state marketplaces, which have provided millions of Americans with insurance under the law.
New York Times, December 6, 2016

5. Insurers’ Flawed Directories Leave Patients Scrambling For In-Network Doctors
Kaiser Health News reports: Penny Gentieu did not intend to phone 308 physicians in six different insurance plans when she started shopping for 2017 health coverage.
Kaiser Health News, December 5, 2016

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

By Claire Thayer, December 2, 2016

1. The drug industry’s stake in Trumpcare is bigger than you think
StatNews reports: The upcoming fight over repealing and replacing the Affordable Care Act promises to shake up hospitals and insurers, but drug makers also stand to gain — or lose — a lot.
StatNews, December 2, 2016

2. 2,000+ physicians: 'The AMA does not speak for us' in supporting Price for HHS
Becker's Hospital Review reports: More than 2,000 physicians signed an open letter railing against the American Medical Association's support for Rep. Tom Price, MD, R-Ga., chairman of the House Budget Committee, as secretary of HHS.
Becker's Hospital Review, December 1, 2016

3. U.S. House Passes 21st Century Cures Legislation
Healthcare Informatics reports: The U.S. House of Representatives today passed sweeping, bipartisan legislation, called the 21st Century Cures Act, comprised of a $6.3 billion package of medical innovation bills including $4.8 billion to the National Institutes of Health as well as $1 billion in state grants to fight opioid abuse.
Healthcare Informatics, November 30, 2016

4. Price’s Appointment Boosts GOP Plans To Overhaul Medicare And Medicaid
Kaiser Health News reports: President-elect Donald Trump’s selection of Rep. Tom Price to head the Department of Health and Human Services signals that the new administration is all-in on both efforts to repeal the Affordable Care Act and restructure Medicare and Medicaid.
Kaiser Health News, November 29, 2016

5. CMS nominee set up Indiana’s unusual Medicaid expansion
The Washington Post reports: A decade ago, when Indiana had one of the lowest rates of health insurance coverage in the nation, then-Gov. Mitch Daniels (R) turned to a health policy consultant named Seema Verma to help insure more of the state’s poor and working poor.
The Washington Post, November 29, 2016

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.

Friday Five: Top 5 healthcare business news items from the MCOL Weekend edition

By Claire Thayer, November 18, 2016

1. Study Finds Nearby Retail Clinics Don’t Drive Down ER Visits
Kaiser Health News Reports: Even if there’s a retail health clinic less than a 10-minute drive away, consumers are just as likely to go to the emergency department for low-level problems like bronchitis or urinary tract infections, a recent study found.
Kaiser Health News, November 18, 2016

2. The ultimate Q&A about health care under a Trump presidency
The Washington Post reports: While it's pretty much a given that the Affordable Care Act won't survive a Trump presidency and Republican Congress in its current form, there are sweeping implications of reversing a law that has reached in so many ways into our health care system.
The Washington Post, November 17, 2016

3. Former Valeant and Philidor Executives Charged in Kickback Scheme
The New York Times reports: A secret relationship had made the two men rich: one, the head of a mail-order pharmacy, the other, an executive at a major pharmaceutical company who had promised to funnel millions of dollars to his partner in exchange for receiving millions of his own.
The New York Times, November 17, 2016

4. Landmark report by Surgeon General calls drug crisis ‘a moral test for America’
The Washington Post reports: A landmark report released Thursday by U.S. Surgeon General Vivek H. Murthy places drug and alcohol addiction alongside smoking, AIDS and other public health crises of the past half-century, calling the current epidemic “a moral test for America.”
The Washington Post, November 17, 2016

5. More than 1 million sign up for ObamaCare, HHS says
The Hill reports: More than 1 million people have registered for ObamaCare coverage for 2017 since the sign-up period began Nov. 1, the Obama administration announced Wednesday.
The Hill, November 16, 2016

These and more weekly news items on the business of healthcare are featured in the MCOL Weekend edition, along with the MCOL Tidbits, and more, for MCOL Premium level members.