Hi, Healthy Musers. Apparently, healthcare startups all use the same font.
5 Big Healthcare Stories, week of April 22, 2019
1. Healthcare Stocks Get Wrecked
BEARISH.
Healthcare is on track to be the worst performing sector since 2006 amidst political drama and existential risks facing the current system, leaving healthcare investors (at least in the public markets) skittish. With 2020 approaching and Medicare for All cries rallying, insurance companies like UnitedHealth, Cigna, Anthem, and Humana have suffered through the few months of the year. Providers fared poorly as well – in fact, the S&P Healthcare Services index ($XHS) is 15% lower than the S&P 500 as a whole (negative for the year!), which is a massive divergence. Don’t forget about the Drug-makers selloff either. Adding fuel to the fire, UnitedHealth’s CEO’s comments on its Q1 conference call seemed to indicate a defensive position – warning those on the 80 minute call how any of the proposals floating in Congress or among Democratic candidates would cause “wholesale disruption” of American healthcare, including jeopardizing the relationship people have with their doctors, destabilizing the nation’s healthcare system, limiting clinicians’ abilities to practice medicine at their best, and a severe impact on jobs and the economy. UnitedHealth urged those seeking reform to work within the current system to find the right solutions and correctly align business incentives with patient outcomes.
2. High-Deductible Health Plans Linked to Delayed Treatment
“I’ll wait.”
That’s what those with high-deductible health plans are saying. To cut down on costs, employers are increasingly switching to high-deductible health plans (HDHPs), which could be causing delays in care for people who might otherwise seek treatments. HDHPs essentially put the patient on the hook for more of the medical bill, making the patient’s out of pocket healthcare costs higher due to the larger deductible (but generally lower premium). These HDHP plans come packaged with a Health Savings Account (but we all know how good most Americans are at saving money). Based on a Health Affairs study, women who were switched from low-deductible to high-deductible health plans waited months longer on average to seek care for various conditions. This factor did not change when income and geographical area were taken into account, either. The issue boils down to the fact that many patients do not have, or do not want to spend, the money needed to seek preventive treatment for their conditions.
3 The Healthcare Cost Blame Game
Whose fault is it anyway?
Healthcare players are all looking for someone to blame when it comes to high prices rather than proposing potential solutions, according to ModernHealthcare. Here are just a few of their perspectives from the main healthcare sub-sectors:
Hospitals. “Insurers are a problem. If hospitals lowered prices, insurers most likely would not pass along those savings to patients anyway.”
Insurers. “Premiums track directly to underlying healthcare costs as calculated by actuaries. We’re not pocketing the extra savings providers generate by cutting costs. Value based payment models and better integration and collaboration with providers should be the way forward.”
Physicians. “It shouldn’t be squarely on us to manage all of our costs. We have large administrative burdens to deal with as it is.”
Big Pharma. “Hospitals mark up drugs to make a higher profit. We’ll charge what we want.”
The article outlines a few potential solutions to high hospital prices, including better alignment with payors (value based care models), giving physicians more responsibility with financial decisions, increasing hospital operational efficiencies and undergoing cost-cutting initiatives, and having employers (as the largest purchasers of insurance) use leverage to negotiate down prices.
4. Congress is Considering Raising the Smoking Age to 21
Tobacco gets smoked.
The Senate is considering raising the smoking age to 21, which would apply to all tobacco products (yes, even vaping). The federal move comes at a time when several states have already passed laws requiring the minimum age of 21. Interestingly, the large tobacco players actually support the legislation, despite the sell-off in their stocks on the news. Since the FDA is cracking down on youth vaping and tobacco products, Big Tobacco probably thinks this move is likely to keep them in somewhat good graces with the Feds.
5. Medical Professionals get Indicted in Opioids Case
You’re in trouble.
That’s what the feds are saying to 53 medical professionals. This week, the DOJ indicted these professionals, charging them with illegally prescribing and distributing opioids. Apparently these medical professionals also committed healthcare fraud. Swell. The opioids case continues to expand in scope, increasing the number of people charged with the crime of spreading the addictive drugs and perpetuating substance abuse nationwide. Some of the stories detailed in the article are absolutely wild.
Quick Hits
Bain & Co. released its 2018 Global Healthcare M&A Report this week. Louisiana might ban any new freestanding emergency rooms. Is there an impending U.S. healthcare crisis? How do insurance plans between America and Europe differ? Here’s the timeline for potential drug pricing rebate reform. In North Carolina, Atrium and Wake Forest are trynna merge in a $13 billion potential transaction. And bio-similars might not create effective competition.
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