DCMedical News: Wednesday, February 27, 2019
DCMedical News-DCMN
Washington, D.C.
Wednesday, February 27, 2019
The publication schedule and subscription information for DCMedical News will be found below.
THE BIG STORY IN HEALTH CARE:
Drug Company CEOs Emerge Unscathed from Senate Finance Committee Hearing, Notwithstanding Gollum:
The widely anticipated hearing featured sober talk from the CEOs, who blamed benefit design in the health insurance industry for high prices. Top Committee Democrat and long-time health expert Senator Wyden said AbbVie protected the patent of Humira (the top selling drug in the U.S.) like “Gollum with his ring.” The CEO group favored passing on discounts and rebates directly to consumers. Limited and qualified support was voiced by the group for a proposal which would compel drug companies to make samples available to potential generic competitors. The New York Times provides “timed” coverage of the hearing (here), beginning with a Senator’s plea to “turn off the lobbyists.”
DOCTORS, NURSES AND OTHER HEALTH PROFESSIONALS
We Value Your Services, Doctor:
Recruitment firm Merritt Hawkins reports on the “value” of medical specialties in generating revenue for hospitals, here. Tops, cardiovascular surgery, at $3.7 million; others in the $3 million-plus club are invasive cardiologists, neurosurgeons and orthopedic surgeons. Bottom, pediatrics, at $1.6 million. Other measures of economic impact: according to this report, each office-based physician supports a “per capita economic output” of $3.1 million, paying $1.4 million to support an average of 17 jobs.
HOSPITALS, NURSING HOMES AND OTHER HEALTH CARE FACILITIES
Tenet Reports on Q4, 2018:
(See also DCMN 2-26-2019 for 10-K link for 2018.) Commenting on the results, CEO Ron Rittenmeyer said (transcript here) they “divested noncore operations, including 17 hospitals and facilities in 2018, and another 3 hospitals just last month These divestitures generated proceeds of over $1 billion, including cash and the elimination of capital lease debt. We did this while continuing to expand our ambulatory portfolio . . . We invested $240 million in Ambulatory M&A including adding 27 facilities and seven new health system partners.”
Hospitals Set Record for Mass. Ballot Initiative Expenditures in Defeating Nurse Staffing Legislation: $25 million, here.
MEDICARE, MEDICAID, COMMERCIAL HEALTH INSURANCE
What Drives Plan Switching?
A Brown University group published a study of disenrollment in JAMA Internal Medicine this week (here). The conclusion: “Results of this study suggest that substantially higher disenrollment from MA plans [Medicare Advantage] occurs among high-need and Medicare-Medicaid eligible enrollees. This study’s findings suggest that star ratings have the strongest association with disenrollment trends, whereas increases in monthly premiums are associated with greater likelihood of switching plans.”
Competition Among Medicare Advantage Plans?
The Commonwealth Fund studies the current concentration of MA markets, possible solutions, here.
Did Narrow Networks Put the “Surprise” Into Surprise Bills?
Paul Ginsburg and colleagues (here) argue in the New England Journal of Medicine for expedited arbitration to resolve out-of-network bills; hospitals argue against compelling members of their medical staffs to participate in hospital-approved health plans (here, from Modern Healthcare); and the New York State Health Foundation publishes a review (here) of the first-in-the-nation 2014 legislation (now in eight other states) for resolution of disputes over surprise bills.
Can States Save Money by Expanding Medicaid? The Commonwealth Fund (CF) says “yes” in a study, here, and a Kaiser Family Foundation study (here) advises states to go for full (not partial) expansion. CF also chronicles (here) the current state of §1332 waivers, and attempts to “grandfather” more non-PPACA compliant plans, as well as the state of Medicaid expansion ballot initiatives (here).
READING AND REFERENCE
U.S. House of Representatives:
Members at https://www.house.gov/representatives, Committees and Members at https://www.house.gov/committees
U. S. Senate:
Members at https://www.senate.gov/general/contact_information/senators_cfm.cfm, Committees and Members at https://www.senate.gov/committees/membership_assignments.htm
House and Senate 2019 Calendar of Regularly Scheduled Sessions, here.
PUBLICATION SCHEDULE FOR DCMEDICAL NEWS
Remaining February publication dates: 28
March publication dates: 1, 4, 5, 6, 7, 8, 11, 12, 13, 14, 15, 25, 26, 27, 28, 29
Notes to: Fred Hyde, MD, JD, MBA; fredhyde@aol.com.