From Capitol Hill, EndPoints News reports
A bill that would cap out-of-pocket insulin costs for the insured at $35 per month remains in limbo as the Congressional Budget Office told the two Senate sponsors of the bill that it will likely increase net prices for insulin, and will increase premiums for commercial health insurance and Medicare Part D.
The comments from the CBO may spell the end for the bill, which is effectively a Band-Aid for a segment of the pharma market that has ballooned in recent years, driving many to ration their life-saving drug.
“Spending for insulin and other pharmaceutical products would increase, CBO estimates, because overall medication use would increase in response to lower cost-sharing requirements,” CBO director Phillip Swagel wrote to Sens. Jeanne Shaheen (D-NH) and Susan Collins (R-ME) on Friday. “Some use of insulin might also shift to newer and more expensive insulin products. Increased spending for pharmaceutical products would result in increased spending for health care overall.”
STAT News adds
Democrats are closer than ever before to finally achieving a goal they’ve been pursuing for nearly two decades — allowing Medicare to negotiate prescription drug prices. Skeptical lawmakers seem to be on board; the bill text is already under review by the Senate’s rules referee. Congressional leadership and the White House have come up with a plan to barrel toward a vote that could come as soon as next week.
Drugmakers, in turn, are intensifying their opposition efforts.
From the Omicron and siblings front
The Wall Street Journal informs us
Charley Ding spent weeks early in the pandemic intubating patients sick with Covid-19. The 42-year-old anesthesiologist in South Barrington, Ill., said he has since watched most of the doctors and nurses he works with get infected at some point.
But he has never gotten Covid-19, he said. “It’s probably a combination of being careful, maybe being blessed with a good immune system,” he said. “But also just luck.”
Dr. Ding is a member of a shrinking club of people who are pretty sure they have never been infected with SARS-CoV-2, the virus that causes Covid-19. Geneticists and immunologists are studying factors that might protect people from infection, and learning why some are predisposed to more severe Covid-19 disease.
For many, the explanation is likely that they have in fact been infected with the virus at some point without realizing it, said Susan Kline, professor of medicine at the University of Minnesota Medical School. About 40% of confirmed Covid-19 cases are asymptomatic, according to a meta-analysis published in December in the Journal of the American Medical Association.
More than two years into the pandemic, most people worldwide have likely been infected with the virus at least once, epidemiologists said. Some 58% of people in the U.S. had contracted Covid-19 through February, the Centers for Disease Control and Prevention has estimated. Since then, a persistent wave driven by offshoots of the infectious Omicron variant thas kept daily known cases in the U.S. above 100,000 for weeks.
As someone who is a member of Dr. Ding’s shrinking club, the FEHBlog thinks that he may have had Covid at some point and in any event, it’s a matter of time before officially contracts it. Covid is gaining similarity to its cousin the common cold.
The FEHBlog has moved his residence inside the Capital Beltway to Dripping Springs, Texas. His Texas residence has a home office. He has come back to work at his DC law firm this week. When working in DC, he stays at a hotel next to his office building. All of this has cut into his commuting time when he listened to Russ Robert’s Econtalk. This evening he traveled up to have dinner with one of his sons outside Baltimore. This allowed him to listen to the July 18 episode of Econtalk during which Russ Roberts discussed Covid with Dr. Vinay Prasad of the University of California San Francisco. Their conversation is very insightful into the public health aspects of the Covid pandemic. It’s worth a listen or read the transcript on the website.
From the public health front, the Department of Health and Human Services announced
Today, the Centers for Medicare & Medicaid Services (CMS) unveiled its Maternity Care Action Plan to support the implementation of the Biden-Harris Administration’s Blueprint for Addressing the Maternal Health Crisis. The action plan takes a holistic and coordinated approach across CMS to improve health outcomes and reduce inequities for people during pregnancy, childbirth, and the postpartum period. CMS’ implementation of the action plan will support the Biden-Harris Administration’s broad vision and call to action to improve maternal health.
“Strengthening maternal health is key to strengthening the health and wellbeing of communities across America,” said HHS Secretary Xavier Becerra. “At HHS, we are taking unprecedented action to advance the Biden-Harris Administration’s vision to improve maternal health and tackle disparities, and I’m proud of the bold action plan CMS has laid out to contribute to our goals. Today is just the beginning: we will tirelessly work to make sure all mothers get the care and support they need.”
Through the action plan, CMS Administrator Chiquita Brooks-LaSure also encouraged industry stakeholders – including health care facilities, insurance companies, state officials, and providers – to consider key commitments the private sector can make to improve maternal health outcomes. Industry can submit proposed commitments at http://cms.gov/maternalhealthcommitments .
From the U.S. healthcare front, Healthcare Dive tells us
The Mayo Clinic earned the No. 1 spot for a seventh straight year in U.S. News & World Report’s best hospitals ranking published Tuesday. Cedars-Sinai Medical Center, NYU Langone Hospitals and the Cleveland Clinic followed next, with Johns Hopkins Hospital and UCLA Medical Center tied in fifth place.
In the specialty rankings, University of Texas MD Anderson Cancer Center was named best in cancer, Cleveland Clinic was first in cardiology and heart surgery, and NYU Langone Hospitals led in neurology and neurosurgery.
U.S. News added three service areas of evaluation this year, for ovarian, prostate and uterine cancer surgeries. The publication also introduced “home time” as an outcome measure in certain ratings, reflecting patients’ preference for recovering at home.
Becker’s Health IT looks at the Amazon – One Medical deal from the perspective of Amazon v. Optum.
From the U.S. healthcare business front, Fierce Healthcare reports
In its latest earnings results, [health insurer Centene] posted a $172 million loss in the second quarter, still beating the Street and slimming its losses compared to the prior year’s quarter. In the second quarter of 2021, Centene reported a $535 million loss, according to its earnings report released Tuesday morning. * * *
The company added about 200,000 members in the second quarter, reaching 26.4 million in total membership. That’s up by more than one million from the second quarter of 2021, when the insurer reported 24.7 million members.
“Our strong second quarter results reflect the consistency of Centene’s product performance,” Centene CEO Sarah London said in a statement. “The second quarter reflects continued execution on our Value Creation Plan with tangible actions and results, providing an excellent foundation from which we will continue to build over the next couple of years.”
From the reports and studies (tidbits?) department —
Health Leaders Media informs us
It’s payers, not providers, that American turn to when seeking out pricing information for healthcare services, according to a survey on price transparency.
The poll, conducted by YouGov on behalf of AI for healthcare operations company AKASA, highlights the need for both insurers and providers to follow pricing regulations for the sake of the patient experience.
Of the 2,026 adults surveyed nationally in March, just 36% indicate they have researched prices for services, of which 60% say they would look to their insurance company for pricing information.
When seeking out information through a payer, 44% would look on the insurer’s website and 29% would call their insurer.
InsuranceNews Net reports
A majority of those who receive health insurance through their employer-provided plan said they are more satisfied with the coverage they receive through work than they are with the current health insurance system overall.
That was one of the key takeaways from research conducted by Locust Street Group and presented at a webinar by America’s Health Insurance Plans. The research was part of AHIP’s Coverage@Work campaign, which aims to educate policymakers and the public about the value of employer-provided coverage.
The survey showed that although 54% of the 1,000 adults surveyed said they are satisfied with the current health system overall, 67% said they were satisfied with the coverage they receive through their employer.
What makes someone satisfied with their coverage? The top three reasons given were:
* Affordability – 45%
* Comprehensive coverage – 45%
* Choice of providers – 44%
Other factors that rounded out the list of reasons for being satisfied included: free preventive services, consistency, customer service, the ability to receive care locally, wellness incentives and innovation.