Tuesday’s Tidbits

David Ermer–Uncategorized–

Here’s a link to House Oversight and Reform subcommittee hearing on the OPM reorganization held this afternoon. At the link, you can find witness testimony and a video recording of the hearing.

Things are looking up for judicial affirmation of the CVS – Aetna merger settlement with Justice Department as a combination of red and blue states who originally opposed the settlement have not filed a brief supporting it, according to Healthcare Dive.  The hearing will be held beginning June 4 in the federal district court in Washington DC.

Fierce Healthcare reports on a study concluding that “there was little variation among primary care physicians when it comes to hospital readmission rates, leaving the researchers questioning whether policies that hold these doctors accountable for reducing readmissions may miss the mark.” If doctors shouldn’t be held responsible for hospital readmissions then why should health plans which has several more degrees of separation from the event be held responsible?

The Kaiser Family Foundation published an interesting study on third party reimbursement of prescription drug costs.

Highlights from this analysis include:

  • Private health insurance, Medicare, and Medicaid accounted for 82% of total retail prescription drug spending in the U.S. in 2017, while patients paid 14% of the total as out-of-pocket payments.
  • For spending on specific drug products, the top five drug products with the highest total spending alone account for at least 10% of total prescription drug spending in large employer plans, Medicare Part D, and Medicaid.
  • While some of the same drug products appear among the top 10 drug products with the highest total spending in large employer plans, Medicare Part D, and Medicaid, there is also variation that reflects differing covered populations.
  • Out-of-pocket drug spending per user among people in large employer plans and Medicare Part D is highest for drugs to treat cancer, multiple sclerosis and rheumatoid arthritis.
  • Antidiabetic agents, antivirals and psychotherapeutics are among the top therapeutic classes by total spending in large employer plans, Medicare Part D, and Medicaid.