May 16, 2019 | Privately insured pay 2.4x Medicare rates
INDUSTRY NEWS
State AGs go after generic drug makers
Attorney generals in 44 states are suing some of the nation’s largest generic drug manufacturers, alleging they conspired to artificially inflate and manipulate prices for more than 100 different generic drugs, including treatments for diabetes, cancer, arthritis and other medical conditions. The lawsuit also names 15 individual senior executives. Among those allegedly involved are Teva, Pfizer, Novartis and Mylan. A key element of the alleged scheme was an agreement among competitors to cooperate on pricing so each company could maintain a “fair share” of the generic drug market. (Associated Press)
TV Rx ads will soon include list prices
Drug manufacturers will soon be required to include the list price in all TV ads, according to a final rule announced last week by Health and Human Services Secretary Alex Azar. The rule will apply to any pharmaceutical covered by Medicare costing $35 or more per month or per course. Drug companies may argue that list prices aren’t important because consumers rarely pay them, but Azar counters that for the 47% of Americans with high-deductible health plans, the list price is the price—at least until they hit the deductible. (MedPage Today)
INNOVATION & TRANSFORMATION
I do not think it means what you think it means
Consumers appear to be warming to Medicare-for-all, but they may not understand what it entails, Dr. Niran Al-Agba writes in a blog post. “Few seem to realize that no other system in the world operates like the current single payer proposals in Congress.” For example, most universal coverage systems incorporate cost-sharing for patients, and private health insurance typically plays an important role. “When it comes to health care reform, our politicians need to stop trying everything else, and just do the right thing the first time. It is not Medicare for all.” (KevinMD)
Deloitte: Digital transformation to upend health care
The health industry is on the cusp of a major revolution, driven by digital transformation enabled by radically interoperable data and open, secure platforms. Health is likely to revolve around sustaining well-being rather than responding to illness, according to a new paper from Deloitte. It anticipates a bright future. “Twenty years from now, cancer and diabetes could join polio as defeated diseases...The onset of disease, in some cases, could be delayed or eliminated altogether. Sophisticated tests and tools could mean most diagnoses (and care) take place at home.” (Deloitte)
CONSUMERS & PROVIDERS
Patients discharged to skilled nursing facilities (SNF) after a hospital stay had a reduced risk of readmission and death if they received even one visit from a clinician, according to research published in Health Affairs. Those patients had a 14.3% hospital readmission rate. SNF patients who received no clinician visits had a 27.9% readmission rate. In addition, SNF patients who received at least one clinician visit had a 7.2% mortality rate. SNF patients who received none had a 14.2% mortality rate. (Health Affairs; HealthLeaders Media)
Hospital study: Privately insured pay 2.4x Medicare rates
Analysis from the RAND Corporation finds that hospitals are charging the privately insured 2.4 times what they charge Medicare patients, on average. Forbes says the analysis, which encompassed hospitals in 25 states, “is in some ways the most important analysis of hospital prices ever done.” The reason: The authors were able to access the actual contracted prices used by employers representing 4 million workers. Normally, the details of these contracts are shrouded in secrecy. (Forbes; RAND analysis)
NEW & NOTED
Old-school health: The New Jersey Hospital Association recently hosted its second “Retro-Activity” event intended to engage college students in health-related activities. Why retro? The students were asked to put down their phone and other devices and remove their earphones. (Modern Healthcare)
Hold on to your cap: Guinness World Records officials denied a British nurse a world record for running the fastest marathon in a nurse’s uniform because she wore scrubs instead of a blue or white dress, apron and a traditional cap. Not for long. Amid protests, it reversed the decision. Jessica Anderson, who finished the London Marathon in a time of 3:08:22, now holds that record. (Fox News)
Naloxone access: In states where pharmacists can sell the opioid antidote naloxone without a prescription, fewer people die from opioid overdoses, according to research published in JAMA Internal Medicine. Researchers also found these states had an increase in visits to the emergency rooms for non-fatal overdoses. (Reuters)
MULTI-MEDIA
This past Sunday, City Church of Evansville, Ind., announced that it will pay off $1.5 million of medical debt for families in the city of Evansville. The church raised $15,000 and is working with a non-profit, RIP Medical Debt, which buys back medical debt for pennies on the dollar for people living at or near poverty level incomes. (WFIE)
MARKETVOICES...QUOTES WORTH READING
“The original sin of the American health care system—the exclusion from taxation of employer-sponsored insurance—has created all sorts of incentives for hospitals, drug companies, and other health care industries to keep raising their prices, knowing that patients are several middlemen removed from the cost and value of the care they receive.”—Avik Roy, writing in Forbes