If you had the option to feel no pain…would you?
1. Amazon’s Alexa is…HIPAA Compliant?
“Alexa, find me a doctor.”
Amazon (aka relentless.com) announced in a blog post this week that its personal assistant, our girl Alexa, is now HIPAA compliant. This means that the smart assistant can now securely access your personal health data on whatever Alexa enabled device you’re using. As a part of the initiative, several high-profile healthcare companies, including Cigna, Express Scripts, Boston Children’s Hospital, and Livongo developed and published ‘Skills’ for the Alexa app for use immediately following Amazon’s announcement. The skills involve allowing patients to check the status of prescription deliveries, receive information on post-op appointments, schedule primary care appointments, and much more.
2. Generic Drugs Expansion
CREATING Drug Competition.
One of the main ways that Congress is looking to combat rising drug costs involves increasing the supply of generic drugs. A lot of highly specialized drugs don’t have generic alternatives, which keeps those drug prices high. This week, the House approved the CREATES Act (now you see what I did with that sub-heading), which makes things a lot easier for generic drug makers to get drug-making approval. The bill has bi-partisan support and may have enough legs to get through legislation, especially since the Trump admin is all about lowering drug costs. The CREATES Act is expected to save about $4 billion over 10 years. Medicare spent about $100 billion on drugs as recently as 2017 – but still, the bill is a start.
3. Express Scripts Reduces the Price of Insulin
Good timing.
Ahead of the pharmacy benefit managers’ hot-seat meeting with Congress this week (yes, last week I told you guys the hearing was on the 4th, but it was re-scheduled to the 9th. I blame bureaucracy), Express Scripts, one of the said PBM companies testifying, conspicuously announced a new plan called the Patient Assurance Program. The new program aims to limit out-of-pocket costs for insulin to $25 per a 30-day prescription. This news is pretty uplifting for diabetes patients, who typically deal with ever-rising insulin costs and shortages of the popular drug. There are caveats, though: the new program will only be accessible to patients who participate in non-government funded plans (i.e., not Medicare or Medicaid), and plans that are managed by the newly combined Express Scripts and Cigna. Currently, the average out of pocket cost for insulin under these plans is about $41.50.
“What were they waiting for?”
That’s what Senator Chuck Grassley pondered wonderously. Via Axios, he had some choice words for the move: “Why couldn’t this have been done years ago? It shouldn’t take bad press and congressional scrutiny to get health plans, their pharmacy benefit managers and pharmaceutical companies to arrive at a fair price for a drug that’s been on the market for nearly a century.”
4. The Stem Cell Industry is out of Control
The modern day snake oil salesmen.
Stem cell therapy clinics have been popping up over the past few years, and the FDA is playing whack-a-mole to shut down the sketchy treatment sites. The shady clinics falsely market their ‘innovative’ stem cell therapies, even going so far as to say that the untested, unproven therapies can cure a variety of diseases and ailments, including uncured ones like Alzheimer’s and multiple sclerosis. The FDA is having none of it, sending dozens of letters to companies in its first pass at reining in the dangerous practices. Quite a few people have gotten hurt from the stem cell clinics, including several who were left blind after someone made the medical decision to have their eyes injected.
I’m skeptical.
It’s a shame because these shady clinics are overshadowing the promising future of stem cell therapies. Actual research shows that stem cell treatments could result in major medical breakthroughs, but the lack of trust propagated by these bad actors in the meantime might set back the industry’s development, especially as some hospitals venture dangerously close to unproven stem cell treatments, too.
5. Surprise Billing Solution
Solution in the works.
Along with controlling drug prices, ‘surprise billing’ is one of the rare public policy problems that has both bipartisan support and active solutions working through Congress. If you need a refresher on what surprise billing is, you can go back and read the 5th story on the February 1st edition. Insurance companies (think United Health) and providers (i.e., physicians) have been spatting for months about who’s to blame when a patient receives an exorbitantly large bill after an emergency visit. This week, panelists met with Congress to work through potential solutions to the issue – one that states have been working on for a while now.
So…any progress?
Main takeaways and ideas from the testifying witnesses included removing the incentives in place for doctors to remain out of network with insurers, forcing arbitration between the insurer, patient, and provider to find a reasonable payment solution, pinning out of network payments to Medicare rates, and implementing a bundled payment for all services rendered (i.e., one payment given for all hospital and physician bills). Most witnesses honed in on limiting the out-of-network status of physicians administering care at hospitals, ESPECIALLY in an emergency setting where patients have little to no say in where they receive care.
Quick Hits
Direct-to-Consumer medicine is picking up speed (i.e., you need Viagra, a company sends you Viagra directly), but at what cost? Encompass Health shelled out $218 million for Alacare Home Health & Hospice, based out of Birmingham – that’s more than double the amount they told investors they’d be spending on M&A in the entirety of 2019. And Trump just gave back ground on his administration’s plan to repeal and replace the ACA…for now.
Maine’s Medicaid expansion plan was approved this week. Alaska might be the first state to apply for Medicaid block grants – meaning the state would get lump payments to manage its Medicaid program. Health Quest and Western Connecticut Health Network are merging to form a $2.4 billion conglomerate called Nuvance Health. And some drug companies are still completely ignoring drug pricing pressures (paywall), raising their drug prices by hundreds of percentages.
Walgreens got hammered (paywall) after announcing its second-quarter results, with its profits squeezed by the push for more generic drugs (they make more money based on the higher cost of drugs). Wal-Mart finds huge savings by picking and choosing the doctors (paywall) that its employees see. Digital health investments slowed down a bit in the first quarter of 2019, but there’s still plenty of fish in the sea. A few states are suing because they don’t like the Trump admin’s new school lunch rules changes (hint – they weakened school nutritional standards for the food they provide). And telehealth use is growing faster than urgent care center use.
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